Biofilm Treatment

ABSTRACT

The invention provides a method of preventing, inhibiting or reducing a  P. gingivalis  biofilm in a subject comprising administering to the subject a pharmaceutical composition comprising an inhibiting agent of a polypeptide that reduces or inhibits biofilm formation and/or biofilm development. Also provided are compositions useful in the prevention, inhibition or treatment of periodontal disease or  P. gingivalis  infection.

FIELD OF THE INVENTION

The present invention relates to compositions and methods for preventingor altering bacterial biofilm formation and/or development such as thosecontaining Porphyromonas gingivalis. In particular the present inventionrelates to the use and inhibition of polypeptides which are importantfor growth as a biofilm or under haem-limitation or to modulate biofilmformation and/or development. The present invention also relates to acomposition for the modulation of biofilm formation and/or development,including by regulating bacterial enzymes.

BACKGROUND OF THE INVENTION

Many bacterial treatments are directed to bacteria in a planktonicstate. However, bacterial pathologies include bacteria in a biofilmstate. For example, Porphyromonas gingivalis is considered to be themajor causative agent of chronic periodontal disease. Tissue damageassociated with the disease is caused by a dysregulated host immuneresponse to P. gingivalis growing as a part of a polymicrobial bacterialbiofilm on the surface of the tooth. Bacterial biofilms are ubiquitousin nature and are defined as matrix-enclosed bacterial populationsadherent to each other and/or to surfaces or interfaces (1). Thesesessile bacterial cells adhering to and growing on a surface as a maturebiofilm are able to survive in hostile environments which can includethe presence of antimicrobial agents, shear forces and nutrientdeprivation.

The Centers for Disease Control and Prevention estimate that 65% ofhuman bacterial infections involve biofilms. Biofilms often complicatetreatment of chronic infections by protecting bacteria from the immunesystem, decreasing antibiotic efficacy and dispersing planktonic cellsto distant sites that can aid reinfection (2,3). Dental plaque is aclassic example of a bacterial biofilm where a high diversity of speciesform a heterogeneous polymicrobial biofilm growing on the surface of thetooth. The surface of the tooth is a unique microbial habitat as it isthe only hard, permanent, non-shedding surface in the human body. Thisallows the accretion of a substantial bacterial biofilm over a lengthytime period as opposed to mucosal surfaces where epithelial cellshedding limits development of the biofilm. Therefore, the changes tothe P. gingivalis proteome that occur between the planktonic and biofilmstates are important to our understanding of the progression of chronicperiodontal disease.

P. gingivalis has been classified into two broad strain groups withstrains including W50 and W83 being described as invasive in animallesion models whilst strains including 381 and ATCC 33277 are describedas less invasive (4,5). Griffen et al. (6) found that W83/W50-likestrains were more associated with human periodontal disease than otherP. gingivalis strains, including 381-like strains, whilst Cutler et al.(7) demonstrated that invasive strains of P. gingivalis were moreresistant to phagocytosis than non-invasive strains. Comparison of thesequenced P. gingivalis W83 strain to the type strain ATCC 33277indicated that 7% of genes were absent or highly divergent in strain33277 indicating that there are considerable differences between thestrains (8). Interestingly P. gingivalis strain W50 forms biofilms onlypoorly under most circumstances compared to strain 33277 which readilyforms biofilms (9). As a consequence of this relatively few studies havebeen conducted on biofilm formation by P. gingivalis W50.

Quantitative proteomic studies have been employed to determine proteomechanges of human bacterial pathogens such as Pseudomonas aeruginosa,Escherichia coli and Streptococcus mutans from the planktonic to biofilmstate using 2D gel electrophoresis approaches, where protein ratios arecalculated on the basis of gel staining intensity (10-12). Analternative is to use stable isotope labelling techniques such as ICAT,iTRAQ or heavy water (H₂ ¹⁸O) with MS quantification (13). The basis forH₂ ¹⁸O labelling is that during protein hydrolysis endopeptidases suchas trypsin have been demonstrated to incorporate two ¹⁸O atoms into theC-termini of the resulting peptides (14,15). In addition to use in thedetermination of relative protein abundances (16-19), ¹⁸O labelling inproteomics has also been used for the identification of the proteinC-terminus, identification of N-linked glycosylation after enzymaticremoval of the glycan, simplification of MS/MS data interpretation andmore recently for validation of phosphorylation sites (20-23). The¹⁶O/¹⁸O proteolytic labelling method for measuring relative proteinabundance involves digesting one sample in H₂ ¹⁶O and the other samplein H₂ ¹⁸O. The digests are then combined prior to analysis by LC MS/MS.Peptides eluting from the LC column can be quantified by measuring therelative signal intensities of the peptide ion pairs in the MS mode. Theincorporation of two ¹⁸O atoms into the C-terminus of digested peptidesby trypsin results in a mass shift of +4 m/z allowing the identificationof the isotope pairs.

Due to the complexity of the proteome, prefractionation steps areadvantageous for increasing the number of peptide and proteinidentifications. Most prefractionation steps involve a 2D LC approach atthe peptide level after in-solution digestion (24,25). However due topotential sample loss during the initial dehydration steps of theprotein solution, SDS PAGE prefractionation at the protein levelfollowed by ¹⁶O/¹⁸O labelling during in gel digestion has also beencarried out successfully, (26-29). The ¹⁶O/¹⁸O proteolytic labelling isa highly specific and versatile methodology but few validation studieson a large scale have been performed (30). An excellent validation studywas carried out by Qian et al (18) who labelled two similar aliquots ofserum proteins in a 1:1 ratio and obtained an average ratio of 1.02±0.23from 891 peptides. A more recent study by Lane et al (26) furtherdemonstrated the feasibility of the ¹⁶O/¹⁸O method using a reverselabelling strategy to determine the relative abundance of 17 cytochromeP450 proteins between control and cytochrome P450 inducers treated micethat are grafted with human tumours.

SUMMARY OF THE INVENTION

This invention used a system whereby P. gingivalis W50 is grown incontinuous culture and a mature biofilm developed on the verticalsurfaces in the chemostat vessel over an extended period of time. Thefinal biofilm is similar to that which would be seen under conditions ofdisease progression, thus allowing a direct comparison between biofilmand planktonic cells. ¹⁶O/¹⁸O proteolytic labelling using a reverselabelling strategy was carried out after SDS-PAGE prefractionation ofthe P. gingivalis cell envelope fraction followed by coupling tooff-line LC MALDI TOF-MS/MS for identification and quantification. Ofthe 116 proteins identified, 81 were consistently found in twoindependent continuous culture studies. 47 proteins with a variety offunctions were found to consistently increase or decrease in abundancein the biofilm cells providing potential targets for biofilm controlstrategies. Of these 47 proteins the present inventors have selected 24proteins which they believe are particular useful as targets intreatment and/or prevention of P. gingivalis infection. These are listedin Table 4 below.

Accordingly, the present invention provides an isolated, purified, orrecombinant bacterial polypeptide that modulates biofilm formation bybacteria. Preferably, the bacteria are anaerobic. In one embodiment, thebacteria are fumarate reductase (Frd) dependent, such as those of genusPorphyromonas. A preferred bacterium is P. gingivalis.

Polypeptides according to the invention for P. gingivalis have an aminoacid sequence selected from the group consisting of sequences listed inTable 4. The invention extends to sequences at least 80% identicalthereto, preferably 85%, 90%, 95%, 96%, 97%, 98%, or 99%.

Another aspect of the invention is a method of preventing or treating asubject for P. gingivalis infection comprising administering to thesubject a pharmaceutical composition comprising an inhibiting agent of apolypeptide that modulates biofilm formation, particularly a P.gingivalis infection resulting from or associated with bacterial biofilmformation. Also provided is a method of preventing or treating a subjectfor periodontal disease comprising administering to the subject apharmaceutical composition comprising an inhibiting agent of apolypeptide that modulates biofilm formation, particularly periodontaldisease resulting from or associated with bacterial biofilm formation.Typically, the polypeptide is important or necessary for biofilmdevelopment in the sense that inhibition of the activity of thepolypeptide reduces or inhibits biofilm formation and/or development.

Also provided is use of an inhibiting agent of a polypeptide thatmodulates biofilm formation in the manufacture of a medicament forpreventing or treating periodontal disease.

Another aspect of the invention is a composition useful in theprevention or treatment of periodontal disease, the compositioncomprising an inhibiting agent such as an antagonist, or combination ofantagonists of the polypeptide of the first aspect of the presentinvention. Typically, the composition will also include apharmaceutically acceptable carrier. The composition is administered sothat the antagonist(s) inhibits infection.

Optionally, the composition may further include one or more antibioticsthat are toxic to or inhibit the growth of Gram negative anaerobicbacteria. Potentially any bacteriostatic or bactericidal antibiotic maybe used in a composition of the invention. Preferably, suitableantibiotics include amoxicillin, doxycycline or metronidazole.

Another aspect of the invention is a composition useful in theprevention, inhibition or treatment of periodontal disease or P.gingivalis infection for use in the oral cavity.

Another aspect of the invention is a composition useful in theprevention, inhibition or treatment of periodontal disease or P.gingivalis infection when used in the oral cavity.

An oral composition may be deposited on teeth or on the gums or both.

The polypeptide may be an enzyme. Preferably the enzyme is involved inorganic acid metabolism, more preferably glutamate/aspartate catabolism.In one embodiment, the polypeptide is fumarate reductase.

Another aspect of the invention is a composition for treatment of P.gingivalis infection comprising as an active ingredient an inhibitingagent of a polypeptide that modulates biofilm formation or development.

In another aspect of the present invention, there is provided aninterfering RNA molecule, the molecule comprising a double strandedregion of at least 19 base pairs in each strand wherein one of thestrands of the double stranded region is substantially complementary toa region of a polynucleotide encoding a polypeptide as described above.In one embodiment, one of the strands is complementary to a region ofpolynucleotide encoding a polypeptide of a sequence listed in Table 4.

In one embodiment, the inhibiting agent is an antagonist of thepolypeptide. For P. gingivalis, the polypeptide may be fumaratereductase and the antagonist is selected from one or more of inhibitingagents of fumarate reductase. Additional suitable inhibiting agentsinclude natural products, that include but are not limited to decursin,verticipyrone, paecilaminol, 5-alkenyl-3,3(2H)-furanones fromStreptomyces spp., nafuredin, mesaconic acid, rotenone, and natural,semi-synthetic and synthetic analogues thereof. In another aspect,inhibiting agents of the current invention may be synthetic compoundsthat include but are not limited to; 2-substituted 4,6-dinitrophenols;mercaptopyridine N-oxide; L-092,201 (Merck Sharpe and Dohme);nitro-imidazoles such as fexindazole megazol benznidazole, MK-436,L-634,549, misonidazole; or benzimidazoles such as albendazole,cambendazole mebendazole, oxfendazole, parebendazole and thiabendazole;or oxantel or morantel. Preferred inhibiting agents are oxantel,morantel or thiabendazole. A particularly preferred inhibiting agent isoxantel.

It will be recognised by the skilled addressee that the selection of theinhibiting agent will be dependent upon number of clinical factors whichdetermine whether the inhibiting agent is appropriate for use in aclinical setting.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1: ¹⁶O/¹⁸O quantification of specific BSA ratios. Quantification ofknown amounts of BSA was carried out in the same manner as for thebiofilm and planktonic samples reported in the experimental proceduresto validate the methodology. Briefly pre-determined amounts of BSA wereloaded in adjacent lanes of a NuPAGE gel followed by excision of bandsof equal size, normal or reverse proteolytic labelling, nanoHPLC andMALDI TOF-MS/MS. (A) MS spectra of BSA tryptic peptide, RHPEYAVSVLLR atknown ¹⁶O:¹⁸O labelling ratios 1:1 (i), 2:1 (ii), 1:5 (iii) and 10:1(iv) showing the characteristic doublet isotopic envelope for ¹⁶O and¹⁸O labelled peptide (S0, S2 and S4 are the measured intensities of theisotopic peaks) (B) SDS PAGE gel of known BSA ratios used for thequantification procedure.

FIG. 2: Typical forward and reverse MS and MS/MS spectra from P.gingivalis sample. (i,ii) Zoomed portion of mass spectra showing the[M+H]+parent precursor ion of the normal and reverse labelled peptideGNLQALVGR belonging to PG2082 and showing the typical 4 Da massdifference in a 1:1 ratio (iii,iv) mass spectrum showing the[M+H]+parent precursor ion of the normal and reverse labelled peptideYNANNVDLNR belonging to PG0232 and showing the typical 4 Da massdifference in a 2:1 ratio (v, vi) MS/MS spectrum of heavy labelled (+218O) YNANNVDLNR and unlabelled YNANNVDLNR peptide characterized by the 4Da shift of all Y ions.

FIG. 3: Correlation of normal/reverse labelled technical replicates.Log10 transformed scatter plot comparison of peptide abundance ratio ofthe normal (Bio18, Plank16) and reverse (Plank18, Bio16) labelling forboth biological replicates. The abundance ratios of the reverse labelledpeptides have been inversed for a direct comparison. (A) Biologicalreplicate 1 (B) Biological replicate 2

FIG. 4: Distribution and correlation of protein abundances of biologicalreplicates. (A) Normalized average fold change for the 81 quantifiableproteins identified in both biological replicates displayed aGaussian-like distribution. The abundance ratio of each protein wasfurther normalized to zero (R−1) and ratios smaller than 1 were invertedand calculated as (1−(1/R)) (18). All 81 quantifiable proteins from eachbiological replicate were sorted by increasing ratios(Biofilm/Planktonic) and divided equally into six groups with equalnumber of proteins (A-F). Groups C and D represents proteins notsignificantly regulated (<3 SD from 1.0). (B) Distribution of proteinsbased on rankings. Insert: ranking table for the determination ofsimilarity between both biological replicates. Proteins were ranked indescending order with 1 having the highest similarity when bothbiological replicates fell within the same group and 6 having the leastsimilarity.

FIG. 5: Breakdown of the 116 proteins identified in this study based onidentification in one or both biological replicates and number of uniquepeptides identified. The proteins identified from both biologicalreplicates (81) are presented in table 2. Legend shows number of uniquepeptides identified per protein.

FIG. 6: The catabolic pathways for glutamate and aspartate fermentationin P. gingivalis. Identified enzymes catalysing each step arerepresented by their TIGR accession number as seen in Table 3.Underlined accession number indicates enzymes that were detected in theanother proteomic analysis but not in the ICAT studies.

FIG. 7: Effect of oxantel on cell growth of P. gingivalis W50 (A) andATCC 33277 (B) over 50 h. The concentrations used were from 15.625 to1000 μM. Negative control used was 4 μL DMSO. MIC and MGT of P.ginvigalis was as noted in Table 7 and 8. Result shows mean of twobiological replicates carried out on different days (n=10). (

DMSO, - 15.625 μM,

31.25 μM,

62.5 μM,

125 μM,

250 μM,

500 μM,

1000 μM)

FIG. 8: Effect of morantel on cell growth of P. gingivalis over 50 h.The concentrations used were from 15.625 to 1000 μM. Negative controlused was 4 μL DMSO. MIC and MGT of P. gingivalis was as noted in Table7. (

DMSO, - 19.53 μM,

39.06 μM,

78.13 μM,

156.25 μM,

312.5 μM,

625 μM,

1250 μM,

2500 μM,

5000 μM)

FIG. 9: Effect of thiabendazole on cell growth of P. gingivalis over 50h. The concentrations used were from 31.25 to 4000 μM. Negative controlused was 4 μL DMSO. MIC and MGT of P. gingivalis was as noted in Table7. (

DMSO, - 31.25 μM,

62.5 μM,

125 μM,

250 μM,

500 μM,

1000 μM,

2000 μM,

4000 μM)

FIG. 10: Effects of oxantel on biofilm formation by P. gingivalis strain33277 (A) 24 h biofilm (B) 48 h biofilm. Biological replicates of theassay were carried out and error bars representing the standarddeviations of both biological replications (n=12).

FIG. 11: CLSM image of the control ATCC 33277 treated with only waterand stained with Baclight. Images are maximum projections of the entirez-stack obtained at 2 μm intervals. Scale bar (white)=10 μm.

FIG. 12: CLSM image of ATCC 33277 treated with 125 μM Oxantel andstained with Baclight. Images are maximum projections of the entirez-stack obtained at 2 μm intervals. Scale bar (white)=10 μm

FIG. 13: CLSM image of the ATCC 33277 treated with 12.5 μM Oxantel andstained with Baclight. Images are maximum projections of the entirez-stack obtained at 2 μm intervals. Scale bar (white)=10 μm

FIG. 14: Colony forming units of P. gingivalis after Oxantel treatmentbased on a static 24 well assay.

DETAILED DESCRIPTION OF THE EMBODIMENTS

Using a proteomic strategy the present inventors successfully identifiedand quantified the changes in abundance of 116 P. gingivalis cellenvelope proteins between the biofilm and planktonic states, with themajority of proteins identified by multiple peptide hits. The presentinventors demonstrated enhanced expression of a large group ofcell-surface located C-Terminal Domain family proteins including RgpA,HagA, CPG70 and PG99. Other proteins that exhibited significant changesin abundance included transport related proteins (HmuY and IhtB),metabolic enzymes (FrdA and FrdB), immunogenic proteins and numerousproteins with as yet unknown functions.

Accordingly, the present invention provides an isolated P. gingivalispolypeptide, the polypeptide having an amino acid sequence selected fromthe group consisting of sequences corresponding to accession numberslisted in Table 4 and sequences at least 95% identical thereto.

Preferably, the isolated polypeptide is at least 96%, 97%, 98%, 99% or100% identical to the amino acid sequence of any one of the sequencescorresponding to the accession numbers listed in Table 4.

The terms “peptides, proteins, and polypeptides” are usedinterchangeably herein. The polypeptides of the present invention caninclude recombinant polypeptides such as fusion polypeptides. Methodsfor the production of a fusion polypeptide are well-known to thoseskilled in the art.

As will be well understood by those skilled in the art alterations maybe made to the amino acid sequences corresponding to the accessionnumbers listed in Table 4. These alterations may be deletions,insertions, or substitutions of amino acid residues. The alteredpolypeptides can be either naturally occurring (that is to say, purifiedor isolated from a natural source) or synthetic (for example, bysite-directed mutagenesis on the encoding DNA). It is intended that suchaltered polypeptides which have at least 85%, preferably at least 90%,95%, 96%, 97%, 98% or 99% identity with the sequences corresponding tothe accession numbers listed in Table 4 are within the scope of thepresent invention. Antibodies raised against these altered polypeptideswill also bind to the polypeptides having one of the sequencescorresponding to the accession numbers listed in Table 4.

Whilst the concept of conservative substitution is well understood bythe person skilled in the art, for the sake of clarity conservativesubstitutions are those set out below.

Gly, Ala, Val, Ile, Leu, Met;

Asp, Glu, Ser;

Asn, Gln;

Ser, Thr;

Lys, Arg, H is;

Phe, Tyr, Trp, H is; and

Pro, Na-alkalamino acids.

The practice of the invention will employ, unless otherwise indicated,conventional techniques of chemistry, molecular biology, microbiology,recombinant DNA, and immunology well known to those skilled in the art.Such techniques are described and explained throughout the literature insources such as, J. Perbal, A Practical Guide to Molecular Cloning, JohnWiley and Sons (1984), J. Sambrook et Molecular Cloning: A LaboratoryManual, Cold Spring Harbour Laboratory Press (1989), T. A. Brown(editor), Essential Molecular Biology: A Practical Approach, Volumes 1and 2, IRL Press (1991), D. M. Glover and B. D. Hames (editors), DNACloning: A Practical Approach, Volumes 1-4, IRL Press (1995 and 1996),and F. M. Ausubel et al. (Editors), Current Protocols in MolecularBiology, Greene Pub. Associates and Wiley-Interscience (1988, includingall updates until present). The disclosure of these texts areincorporated herein by reference.

An “isolated polypeptide” as used herein refers to a polypeptide thathas been separated from other proteins, lipids, and nucleic acids withwhich it naturally occurs or the polypeptide or peptide may besynthetically synthesised. Preferably, the polypeptide is also separatedfrom substances, for example, antibodies or gel matrix, for example,polyacrylamide, which are used to purify it. Preferably, the polypeptideconstitutes at least 10%, 20%, 50%, 70%, and 80% of dry weight of thepurified preparation. Preferably, the preparation contains a sufficientamount of polypeptide to allow for protein sequencing (ie at least 1,10, or 100 mg).

The isolated polypeptides described herein may be purified by standardtechniques, such as column chromatography (using various matrices whichinteract with the protein products, such as ion exchange matrices,hydrophobic matrices and the like), affinity chromatography utilizingantibodies specific for the protein or other ligands which bind to theprotein.

A “contiguous amino acid sequence” as used herein refers to a continuousstretch of amino acids.

A “recombinant polypeptide” is a polypeptide produced by a process thatinvolves the use of recombinant DNA technology.

In determining whether or not two amino acid sequences fall within aspecified percentage limit, those skilled in the art will be aware thatit is necessary to conduct a side-by-side comparison or multiplealignments of sequences. In such comparisons or alignments, differenceswill arise in the positioning of non-identical residues, depending uponthe algorithm used to perform the alignment. In the present context,reference to a percentage identity or similarity between two or moreamino acid sequences shall be taken to refer to the number of identicaland similar residues respectively, between said sequences as determinedusing any standard algorithm known to those skilled in the art. Forexample, amino acid sequence identities or similarities may becalculated using the GAP programme and/or aligned using the PILEUPprogramme of the Computer Genetics Group, Inc., University ResearchPark, Madison, Wis., United States of America (Devereaux et al et al.,1984). The GAP programme utilizes the algorithm of Needleman and Wunsch(1970) to maximise the number of identical/similar residues and tominimise the number and length of sequence gaps in the alignment.Alternatively or in addition, wherein more than two amino acid sequencesare being compared, the Clustal W programme of Thompson et al, (1994) isused.

One aspect of the invention is a method of preventing or treating asubject for periodontal disease comprising administering to the subjecta pharmaceutical composition according to the present invention.

In one method a subject is treated including prophylactic treatment forperiodontal disease. Periodontal diseases range from simple guminflammation to serious disease that results in major damage to the softtissue and bone that support the teeth. Periodontal disease includesgingivitis and periodontitis. Bacteria, such as P. gingivalis causesinflammation of the gums that is called “gingivitis.” In gingivitis, thegums become red, swollen and can bleed easily. When gingivitis is nottreated, it can advance to “periodontitis” (which means “inflammationaround the tooth.”). In periodontitis, gums pull away from the teeth andform “pockets” that are infected. The body's immune system fights thebacteria as the plaque spreads and grows below the gum line. If nottreated, the bones, gums, and connective tissue that support the teethare destroyed. The teeth may eventually become loose and have to beremoved.

The present invention also provides a composition useful in theprevention or treatment of periodontal disease, the compositioncomprising an antagonist of a P. gingivalis polypeptide of the firstaspect of the present invention and a pharmaceutically acceptablecarrier, wherein the antagonist inhibits P. gingivalis infection.

An oral composition of this invention which contains the above-mentionedpharmaceutical composition may be prepared and used in various formsapplicable to the mouth such as dentifrice including toothpastes,toothpowders and liquid dentifrices, mouthwashes, troches, chewing gums,dental pastes, gingival massage creams, gargle tablets, dairy productsand other foodstuffs. An oral composition according to this inventionmay further include additional well known ingredients depending on thetype and form of a particular oral composition.

In certain preferred forms of the invention the oral composition may besubstantially liquid in character, such as a mouthwash or rinse. In sucha preparation the vehicle is typically a water-alcohol mixture desirablyincluding a humectant as described below. Generally, the weight ratio ofwater to alcohol is in the range of from about 1:1 to about 20:1. Thetotal amount of water-alcohol mixture in this type of preparation istypically in the range of from about 70 to about 99.9% by weight of thepreparation. The alcohol is typically ethanol or isopropanol. Ethanol ispreferred.

The pH of such liquid and other preparations of the invention isgenerally in the range of from about 5 to about 9 and typically fromabout 5.0 to 7.0. The pH can be controlled with acid (e.g. citric acidor benzoic acid) or base (e.g. sodium hydroxide) or buffered (as withsodium citrate, benzoate, carbonate, or bicarbonate, disodium hydrogenphosphate, sodium dihydrogen phosphate, etc).

In other desirable forms of this invention, the pharmaceuticalcomposition may be substantially solid or pasty in character, such astoothpowder, a dental tablet or a toothpaste (dental cream) or geldentifrice. The vehicle of such solid or pasty oral preparationsgenerally contains dentally acceptable polishing material.

In a toothpaste, the liquid vehicle may comprise water and humectanttypically in an amount ranging from about 10% to about 80% by weight ofthe preparation. Glycerine, propylene glycol, sorbitol and polypropyleneglycol exemplify suitable humectants/carriers. Also advantageous areliquid mixtures of water, glycerine and sorbitol. In clear gels wherethe refractive index is an important consideration, about 2.5-30% w/w ofwater, 0 to about 70% w/w of glycerine and about 20-80% w/w of sorbitolare preferably employed.

Toothpaste, creams and gels typically contain a natural or syntheticthickener or gelling agent in proportions of about 0.1 to about 10,preferably about 0.5 to about 5% w/w. A suitable thickener is synthetichectorite, a synthetic colloidal magnesium alkali metal silicate complexclay available for example as Laponite (e.g. CP, SP 2002, D) marketed byLaporte Industries Limited. Laponite D is, approximately by weight58.00% SiO₂, 25.40% MgO, 3.05% Na₂O, 0.98% Li₂O, and some water andtrace metals. Its true specific gravity is 2.53 and it has an apparentbulk density of 1.0 g/ml at 8% moisture.

Other suitable thickeners include Irish moss, iota carrageenan, gumtragacanth, starch, polyvinylpyrrolidone, hydroxyethylpropylcellulose,hydroxybutyl methyl cellulose, hydroxypropyl methyl cellulose,hydroxyethyl cellulose (e.g. available as Natrosol), sodiumcarboxymethyl cellulose, and colloidal silica such as finely groundSyloid (e.g. 244). Solubilizing agents may also be included such ashumectant polyols such propylene glycol, dipropylene glycol and hexyleneglycol, cellosolves such as methyl cellosolve and ethyl cellosolve,vegetable oils and waxes containing at least about 12 carbons in astraight chain such as olive oil, castor oil and petrolatum and esterssuch as amyl acetate, ethyl acetate and benzyl benzoate.

It will be understood that, as is conventional, the oral preparationswill usually be sold or otherwise distributed in suitable labelledpackages. Thus, a bottle of mouth rinse will have a label describing it,in substance, as a mouth rinse or mouthwash and having directions forits use; and a toothpaste, cream or gel will usually be in a collapsibletube, typically aluminium, lined lead or plastic, or other squeeze, pumpor pressurized dispenser for metering out the contents, having a labeldescribing it, in substance, as a toothpaste, gel or dental cream.

Organic surface-active agents may be used in the compositions of thepresent invention to achieve increased prophylactic action, assist inachieving thorough and complete dispersion of the active agentthroughout the oral cavity, and render the instant compositions morecosmetically acceptable. The organic surface-active material ispreferably anionic, non-ionic or ampholytic in nature and preferablydoes not interact with the active agent. It is preferred to employ asthe surface-active agent a detersive material which imparts to thecomposition detersive and foaming properties. Suitable examples ofanionic surfactants are water-soluble salts of higher fatty acidmonoglyceride monosulfates, such as the sodium salt of the monosulfatedmonoglyceride of hydrogenated coconut oil fatty acids, higher alkylsulfates such as sodium lauryl sulfate, alkyl aryl sulfonates such assodium dodecyl benzene sulfonate, higher alkylsulfo-acetates, higherfatty acid esters of 1,2-dihydroxy propane sulfonate, and thesubstantially saturated higher aliphatic acyl amides of lower aliphaticamino carboxylic acid compounds, such as those having 12 to 16 carbonsin the fatty acid, alkyl or acyl radicals, and the like. Examples of thelast mentioned amides are N-lauroyl sarcosine, and the sodium,potassium, and ethanolamine salts of N-lauroyl, N-myristoyl, orN-palmitoyl sarcosine which should be substantially free from soap orsimilar higher fatty acid material. The use of these sarconite compoundsin the oral compositions of the present invention is particularlyadvantageous since these materials exhibit a prolonged marked effect inthe inhibition of acid formation in the oral cavity due to carbohydratesbreakdown in addition to exerting some reduction in the solubility oftooth enamel in acid solutions. Examples of water-soluble non-ionicsurfactants suitable for use are condensation products of ethylene oxidewith various reactive hydrogen-containing compounds reactive therewithhaving long hydrophobic chains (e.g. aliphatic chains of about 12 to 20carbon atoms), which condensation products (“ethoxamers”) containhydrophilic polyoxyethylene moieties, such as condensation products ofpoly (ethylene oxide) with fatty acids, fatty alcohols, fatty amides,polyhydric alcohols (e.g. sorbitan monostearate) and polypropyleneoxide(e.g. Pluronic materials).

The surface active agent is typically present in amount of about 0.1-5%by weight. It is noteworthy, that the surface active agent may assist inthe dissolving of the active agent of the invention and thereby diminishthe amount of solubilizing humectant needed.

Various other materials may be incorporated in the oral preparations ofthis invention such as whitening agents, preservatives, silicones,chlorophyll compounds and/or ammoniated material such as urea,diammonium phosphate, and mixtures thereof. These adjuvants, wherepresent, are incorporated in the preparations in amounts which do notsubstantially adversely affect the properties and characteristicsdesired.

Any suitable flavouring or sweetening material may also be employed.Examples of suitable flavouring constituents are flavouring oils, e.g.oil of spearmint, peppermint, wintergreen, sassafras, clove, sage,eucalyptus, marjoram, cinnamon, lemon, and orange, and methylsalicylate. Suitable sweetening agents include sucrose, lactose,maltose, sorbitol, xylitol, sodium cyclamate, perillartine, AMP(aspartyl phenyl alanine, methyl ester), saccharine, and the like.Suitably, flavour and sweetening agents may each or together comprisefrom about 0.1% to 5% more of the preparation.

The compositions of this invention can also be incorporated in lozenges,or in chewing gum or other products, e.g. by stirring into a warm gumbase or coating the outer surface of a gum base, illustrative of whichare jelutong, rubber latex, vinylite resins, etc., desirably withconventional plasticizers or softeners, sugar or other sweeteners orsuch as glucose, sorbitol and the like.

In a further aspect, the present invention provides a kit of partsincluding (a) a composition of polypeptide inhibitory agent and (b) apharmaceutically acceptable carrier. Desirably, the kit further includesinstructions for their use for inhibiting biofilm formation in a patentin need of such treatment.

Compositions intended for oral use may be prepared according to anymethod known in the art for the manufacture of pharmaceuticalcompositions and such compositions may contain one or more agentsselected from the group consisting of sweetening agents, flavouringagents, colouring agents and preserving agents in order to providepharmaceutically elegant and palatable preparations. Tablets contain theactive ingredient in admixture with non-toxic pharmaceuticallyacceptable excipients which are suitable for the manufacture of tablets.These excipients may be for example, inert diluents, such as calciumcarbonate, sodium carbonate, lactose, calcium phosphate or sodiumphosphate; granulating and disintegrating agents, for example, cornstarch, or alginic acid; binding agents, for example starch, gelatin oracacia, and lubricating agents, for example magnesium stearate, stearicacid or talc. The tablets may be uncoated or they may be coated by knowntechniques to delay disintegration and absorption in thegastrointestinal tract and thereby provide a sustained action over alonger period. For example, a time delay material such as glycerylmonosterate or glyceryl distearate may be employed.

Formulations for oral use may also be presented as hard gelatin capsuleswherein the active ingredient is mixed with an inert solid diluent, forexample, calcium carbonate, calcium phosphate or kaolin, or as softgelatin capsules wherein the active ingredient is mixed with water or anoil medium, for example peanut oil, liquid paraffin or olive oil.

Aqueous suspensions contain the active materials in admixture withexcipients suitable for the manufacture of aqueous suspensions. Suchexcipients are suspending agents, for example sodiumcarboxymethylcellulose, methylcellulose, hydropropyl methylcellulose,sodium alginate, polyvinylpyrrolidone, gum tragacanth and gum acacia;dispersing or wetting agents may be a naturally-occurring phosphatide,for example, lecithin, or condensation products of an alkylene oxidewith fatty acids, for example polyoxyethylene stearate, or condensationproducts of ethylene oxide with long chain aliphatic alcohols, forexample heptadecaethyleneoxycetanol, or condensation products ofethylene oxide with partial esters derived from fatty acids and ahexitol such as polyoxyethylene sorbitol monooleate, or condensationproducts of ethylene oxide with partial esters derived from fatty acidsand hexitol anhydrides, for example polyethylene sorbitan monooleate.

The aqueous suspensions may also contain one or more preservatives, forexample benzoates, such as ethyl, or n-propyl p-hydroxybenzoate, one ormore colouring agents, one or more flavouring agents, and one or moresweetening agents, such as sucrose or saccharin.

Oily suspensions may be formulated by suspending the active ingredientsin a vegetable oil, for example arachis oil, olive oil, sesame oil orcoconut oil, or in a mineral oil such as liquid paraffin. The oilysuspensions may contain a thickening agent, for example beeswax, hardparaffin or cetyl alcohol. Sweetening agents such as those set forthabove, and flavouring agents may be added to provide palatable oralpreparations. These compositions may be preserved by the addition of ananti-oxidant such as ascorbic acid.

Comparisons of P. gingivalis protein abundances between growth as abiofilm and the planktonic state revealed many changes to the proteomeof this pathogenic bacterium, in particular the lower abundance of thefumarate reductase enzymes essential for glutamate/aspartate catabolism.In a separate study involving comparing the proteome changes ofhaem-limited and excess P. gingivalis, there was an observable shift infermentation patterns during haem-limitation which lead to increasedacetate production and was consistent with the co-ordinated changes inabundance of enzymes in the major catabolic pathway of P. gingivalis. Ofparticular interest was the consistent lower abundance of the fumaratereductase enzymes during haem-limitation and biofilm growth. The presentinventors subsequently demonstrated the utility of three Frd inhibitingagents (oxantel, morantel and thiabendazole) against P. gingivalissurvival and sub minimal inhibitory concentrations (subMIC) to disruptnormal development of the biofilm.

As used herein, the term “antagonist” refers to a nucleic acid, peptide,antibody, ligands or other chemical entity which inhibits the biologicalactivity of the polypeptide of interest. A person skilled in the artwould be familiar with techniques of testing and selecting suitableantagonists of a specific protein, such techniques would include bindingassays.

The antibodies and antagonists of the present invention have a number ofapplications, for example, they can be used as antimicrobialpreservatives, in oral care products (toothpastes and mouth rinses) forthe control of dental plaque and suppression of pathogens associatedwith dental caries and periodontal diseases. The antibodies andantagonists of the present invention may also be used in pharmaceuticalpreparations (eg, topical and systemic anti-infective medicines).

The present invention also provides interfering RNA molecules which aretargeted against the mRNA molecules encoding the polypeptides of thefirst aspect of the present invention. Accordingly, in a seventh aspectof the present invention there is provided an interfering RNA molecule,the molecule comprising a double stranded region of at least 19 basepairs in each strand wherein one of the strands of the double strandedregion is complementary to or capable of hybridizing under normalintracellular conditions with a region of an mRNA molecule encoding apolypeptide of the first aspect of the invention.

So called RNA interference or RNAi is known and further informationregarding RNAi is provided in Hannon (2002) Nature 418: 244-251, andMcManus & Sharp (2002) Nature Reviews: Genetics 3(10): 737-747, thedisclosures of which are incorporated herein by reference.

The present invention also contemplates chemical modification(s) ofsiRNAs that enhance siRNA stability and support their use in vivo (seefor example, Shen et al. (2006) Gene Therapy 13: 225-234). Thesemodifications might include inverted abasic moieties at the 5′ and 3′end of the sense strand oligonucleotide, and a single phosphorthioatelinkage between the last two nucleotides at the 3′ end of the antisensestrand.

It is preferred that the double stranded region of the interfering RNAcomprises at least 20, preferably at least 25, and most preferably atleast 30 base pairs in each strand of the double stranded region. Thepresent invention also provides a method of treating a subject forperiodontal disease comprising administering to the subject at least oneof the interfering RNA molecules of the invention.

Throughout this specification the word “comprise”, or variations such as“comprises” or “comprising”, will be understood to imply the inclusionof a stated element, integer or step, or group of elements, integers orsteps, but not the exclusion of any other element, integer or step, orgroup of elements, integers or steps.

All publications mentioned in this specification are herein incorporatedby reference. Any discussion of documents, acts, materials, devices,articles or the like which has been included in the presentspecification is solely for the purpose of providing a context for thepresent invention. It is not to be taken as an admission that any or allof these matters form part of the prior art base or were common generalknowledge in the field relevant to the present invention as it existedin Australia or elsewhere before the priority date of each claim of thisapplication.

It will be appreciated by persons skilled in the art that numerousvariations and/or modifications may be made to the invention as shown inthe specific embodiments without departing from the spirit or scope ofthe invention as broadly described. The present embodiments are,therefore, to be considered in all respects as illustrative and notrestrictive. The invention specifically includes all combinations offeatures described in this specification.

In order that the nature of the present invention may be more clearlyunderstood, preferred aspects of the invention will now be described inmore detail with reference to the following tables and examples ofcompositions.

Growth and Harvesting of P. gingivalis for Biofilm v Planktonic Studies

Porphyromonas gingivalis W50 (ATCC 53978) was grown in continuousculture using a model C-30 BioFlo chemostat (New Brunswick Scientific)with a working volume of 400 mL. Both the culture vessel and mediumreservoir were continuously gassed with 10% CO₂ and 90% N₂. The growthtemperature was 37° C. and the brain heart infusion growth medium(Oxoid) was maintained at pH 7.5. Throughout the entire growth, redoxpotential maintained at −300 mV. The dilution rate was 0.1 h⁻¹, giving amean generation time (MGT) of 6.9 h. Sterile cysteine-HCl (0.5 g/L) andhemin (5 mg/L) were added. The culture reached steady stateapproximately 10 days after inoculation and was maintained for a further30 days until a thick layer of biofilm had developed on the verticalsurfaces of the vessel.

All bacterial cell manipulations were carried out on ice or at 4° C.During harvesting, the planktonic cells were decanted into a cleancontainer and the biofilm washed twice gently with PGA buffer (10.0 mMNaH₂ PO₄, 10.0 mM KCl, 2.0 mM, citric acid, 1.25 mM MgCl₂, 20.0 mMCaCl₂, 25.0 mM ZnCl₂, 50.0 mM MnCl₂, 5.0 mM CuCl₂, 10.0 mM CoCl₂, 5.0mMH₃ BO₃, 0.1 mMNa₂ Moa_(t), 10 mM cysteine-HCl with the pH adjusted to7.5 with 5 M NaOH at 37° C.) followed by harvesting of the biofilm intoa 50 mL centrifuge tube.

Planktonic and biofilm cells were then washed 3 times (7000 g) with PGAbuffer and both samples resuspended to a final volume of 30 mL with washbuffer (50 mM Tris-HCl, 150 mM NaCl, 5 mM MgCl₂, pH 8.0, proteinaseinhibitor (Sigma)) and lysed by 3 passages through a French PressPressure Cell (SLM, AMINCO) at 138 MPa. The lysed cells were centrifugedat 2000 g for 30 min to remove any unbroken cells. The supernatant wasfurther centrifuged at 100000 g for 1 h to separate the lysed cells intotheir soluble and insoluble (cell envelope) fractions. The cell envelopefraction was further washed 3 times with wash buffer at 100000 g, for 20min each to remove any soluble contaminations. All samples were thenfrozen and stored at 80° C.

Growth and Harvesting of P. gingivalis for Haem-Limitation and ExcessStudies

P. gingivalis W50 was grown in continuous culture using a Bioflo 110fermenter/bioreactor (New Brunswick Scientific) with a 400 mL workingvolume. The growth medium was 37 g/L brain heart infusion medium (Oxoid)supplemented with 5 mg/mL filter sterilized cysteine hydrochloride, 5.0μg/mL haemin (haem-excess) or 0.1 μg/mL haemin (haem-limited). Growthwas initiated by inoculating the culture vessel with a 24 h batchculture (100 mL) of P. gingivalis grown in the same medium(haem-excess). After 24 h of batch culture growth, the medium reservoirpump was turned on and the medium flow adjusted to give a dilution rateof 0.1 h⁻¹ (mean generation time (MGT) of 6.9 h). The temperature of thevessel was maintained at 37° C. and the pH at 7.4±0.1. The culture wascontinuously gassed with 5% CO₂ in 95% N₂. Cells were harvested duringsteady state growth, washed three times with wash buffer (50 mM Tris-HClpH 8.0, 150 mM NaCl, 5 mM MgCl₂) at 5000 g for 30 min and disrupted with3 passes through a French Pressure Cell (SLM, AMINCO) at 138 MPa. Thelysed cells were then centrifuged at 2000 g for 30 min to removeunbroken cells followed by ultracentrifugation at 100000 g, producing asoluble (supernatant) and membrane fraction. All fractions were carriedout on ice.

Preparation and Analysis of ¹⁸O Proteolytic Labelled Biofilm andPlanktonic Cell Envelope Fraction

The cell envelope fraction was first resuspended in 1 mL of ice coldwash buffer containing 2% SDS, then sonication and vortexing werecarried out to aid resuspension of the pellet. The final step inresuspension involved use of a 29-gauge-insulin needle to help break upparticulates. The mixture was then centrifuged at 40000 g to removeinsoluble particles and the protein concentration of the supernatant wasdetermined using the BCA reagent (Pierce) according to themanufacturer's instructions.

The resuspended samples were subjected to precipitation using 5 volumesof ice cold acetone overnight at −20° C. which further helped toinactivate any proteolytic activity. After acetone precipitation, bothsamples were resuspended to a final concentration of 3 mg/mL with 25 mMTris pH 8.0 and 1% SDS assisted by intermittent sonication, vortexingand the use of a 29-gauge-insulin needle. A second BCA protein assay wasthen carried out to standardize the final protein amount.

Gel electrophoresis on a NuPAGE gel was carried out as permanufacturer's protocol using MOPs running buffer (NuPAGE, Invitrogen)except the samples were boiled at 99° C. for 5 min prior to loading ontoa 10-well 10% NuPAGE gel with MOPs as the running buffer. The biofilmand planktonic samples (30 μg each) were loaded in adjacent lanes on thegel. SDS-PAGE was then carried out at 126 V (constant) at 4° C. untilthe dye front was approximately 1 cm from the bottom of the gel. For thebiological replicate, the gel used was a 4-12% NUPAGE gradient gel usingMOPs as the running buffer to give a similar but not exact pattern ofseparation so as to overcome the potential variation of a protein bandbeing separated into two fractions. Staining was carried out overnightin Coomassie brilliant blue G-250 (31) followed by overnight destainingin ultrapure H₂O.

The two gel lanes were divided into 10 gel bands of equal sizes using acustom made stencil and each section cut into approximately 1 mm³ cubes.Destaining was carried out 3 times in a solution of 50 mM NH₄HCO₃/ACN(1:1). After destaining, the gel cubes were dehydrated with 100% ACN,followed by rehydration/reduction with a solution of 10 mMdithiothreitol in ABC buffer (50 mM NH₄HCO₃) at 56° C. for 30 min. Theexcess solution was removed before adding 55 mM iodoacetamide in ABCbuffer for 60 min at room temperature in the dark. After the alkylationreaction, the gel cubes were washed 3 times in ABC buffer, followed bydehydration twice in 100% ACN for 10 min. The gel cubes were furtherdried under centrifugation using a speedvac for 90 min. Digestion wascarried out in 60 μL solution per gel section containing 2 μg ofsequence grade modified trypsin (Promega) and ½ strength ABC buffer madeup in either H₂ ¹⁶O or H₂ ¹⁸O (H₂ ¹⁸O, >97% purity, Marshall Isotopes)for 20 h at 37° C. After digestion, the peptides were twice extractedfrom the gel using a solution of 50% ACN/0.1% TFA in their respectivewater (H₂ ¹⁶O/H₂ ¹⁸O) and 0.1% TFA with the aid of sonication for 5 mineach. The pooled extract was boiled at 99° C. for 5 min to inactivatethe trypsin followed by freeze drying for 48 h.

The freeze-dried peptides were resuspended in a solution of 5% ACN/0.1%TFA in their respective water (H₂ ¹⁶O/H₂ ¹⁸O) just before analysis usingnanoHPLC and MALDI TOF-MS/MS analysis. The peptide solution (20 μL) wasthen loaded onto an Ultimate Nano LC system (LC Packings) using a FAMOSautosampler (LC Packings) in advanced μL pickup mode. The samples werefirst loaded onto a trapping column (300 μm internal diameter×5 mm) at200 μL/min for 5 min. Separation was achieved using a reverse phasecolumn (LC Packings, C18 PepMap100, 75 μm i.d.×15 cm, 3 μm, 100 Å) witha flow rate of 300 mL/min, and eluted in 0.1% formic acid with an ACNgradient of 0-5 min (0%), 5-10 min (0-16%), 10-90 min (16-80%), 90-100min (80-0%).

Eluents were spotted straight onto pre-spotted anchorchip plates (BrukerDaltonics) using the Proteineer Fc robot (Bruker Daltonics) at 30 sintervals. Prior to spotting, each spot position was pre-spotted with0.2 μL of ultrapure H₂O to reduce the concentration of the acetonitrileduring the crystallization process with the matrix. The plate was washedwith 10 mM ammonium phosphate and 0.1% TFA and air-dried beforeautomated analysis using a MALDI-TOF/TOF (Ultraflex with LIFT IIupgrade, Bruker Daltonics). MS analysis of the digest was initiallycarried out in reflectron mode measuring from 800 to 3500 Da using anaccelerating voltage of 25 kV. All MS spectra were produced from 8 setsof 30 laser shots, with each set needing to have a signal to noise,S/N>6, Resolution >3000 to be included. Calibration of the instrumentwas performed externally with [M+H]⁺ ions of the prespotted internalstandards (Angiotensin II, Angiotensin I, Neurotensin, Renin_substrateand ACTH_Clip) for each group of four samples. LIFT mode forMALDI-TOF/TOF was carried out in a fully automated mode using theFlexcontrol and WarpLC software (Bruker Daltonics). In the TOF1 stage,all ions were accelerated to 8 kV and subsequently lifted to 19 kV inthe LIFT cell and all MS/MS spectra were produced from accumulating 550consecutive laser shots.

Selection of parent precursors was carried out using the WarpLC software(ver 1.0) with the LC MALDI SILE (Stable Isotope Labelling Experiment)work flow. Only the most abundant peak of each heavy or light pairseparated by 4 Da was selected, providing its S/N was >50. Compoundsseparated by less than six LC MALDI fractions were considered the sameand therefore selected only once.

Peak lists were generated using Flexanalysis 2.4 Build 11 (BrukerDaltonics) with the Apex peak finder algorithm with S/N>6. The MS scanwas smoothed once with the Savitzky Golay algorithm using a width of 0.2m/z and baseline subtraction was achieved using the Median algorithmwith flatness of 0.8.

Protein identification was achieved using the MASCOT search engine(MASCOT version 2.1.02, Matrix Science) on MS/MS data queried againstthe P. gingivalis database obtained from The Institute for GenomicResearch (TIGR) website (www.tigr.org). MASCOT search parameters were:charge state 1+, trypsin as protease, one missed cleavage allowed and atolerance of 250 ppm for MS and 0.8 m/z for MS/MS peaks. Fixedmodification was set for carbamidomethyl of cysteine and variablemodification was C-terminal ¹⁸O labelled lysine and arginine residues.

A reverse database strategy as described previously (32) was employed todetermine the minimum peptide MASCOT score required to omit falsepositives for single peptide identification. Briefly, the databaseconsists of both the sequence of every predicted P. gingivalis proteinin its normal orientation and the same proteins with their sequencereversed (3880 sequences). The whole MS/MS dataset was then searchedagainst the combined database to determine the lowest Mascot score togive 0% false positives. A false positive was defined as a positivematch to the reversed sequence (bold red and above peptide thresholdscore). A false positive rate for single hit peptides was determined tobe 0.5% with Mascot peptide ion scores of >threshold and <25. When theMascot peptide ion score was >30, there was no match to the reversedatabase. In order to increase the confidence of identification forsingle hits peptide, we used a minimum Mascot peptide ion score of >50which gives a two order of magnitude lower probability of incorrectidentification than if a score of 30 was used, according to the Mascotscoring algorithm.

The matched peptides were evaluated using the following criteria, i) atleast 2 unique peptides with a probability based score corresponding toa p-value <0.05 were regarded as positively identified (required boldred matches) where the score is −log×10log(P) and P is the probabilitythat the observed match is a random event (33), ii) where only oneunique peptide was used in the identification of a specific protein(identification of either heavy or light labelled peptide is consideredas one) the MASCOT peptide ion score must be above 50 or that peptide isidentified in more than one of the four independent experiments (2biological replicates and 2 technical replicates).

Due to the mixed incorporation of one or two ¹⁸O atoms into thepeptides, the contribution of the natural abundance of the ¹⁸O isotopeand the H₂ ¹⁸O purity (a=0.97), the ratios of the peptides R weremathematically corrected using equation:

R=(I ₁ +I ₂)/I ₀  (1)

I₀, I₁ and I₂ were calculated according to the following equations (27),

$\begin{matrix}{I_{1} = \frac{{aS}_{2} - {\left\lbrack {{aJ}_{2} - {2\left( {1 - a} \right)J_{4}}} \right\rbrack S_{0}} - {2\left( {1 - a} \right)S_{4}}}{a^{2} - {\left( {2 - a - a^{2}} \right)J_{2}} + {2\left( {1 - a} \right)^{2}J_{4}}}} & (2) \\{I_{0} = {S_{0} - {\left( {1 - a} \right)I_{1}}}} & (3) \\{I_{2} = {\frac{1}{a^{2}}\left( {S_{4} - {J_{4}I_{0}} - {J_{2}I_{1}}} \right)}} & (4)\end{matrix}$

Where S₀, S₂ and S₄ are the measured intensities of the monoisotopicpeak for peptide without ¹⁸O label, the peak with 2 Da higher than themonoisotopic peak, and the peak with 4 Da higher than the monoisotopicpeak respectively (FIG. 1A). J₀, J₂ and J₄ are the correspondingtheoretical relative intensities of the isotopic envelope of the peptidecalculated from MS-Isotope (http://prospector.ucsf.edu). However whenthe intensity of the second isotopic peaks (S₁ and S₅) was more intensethan the first isotopic peaks (S₀ and S₄), the ratio was simplycalculated as S₁ divided by S₅. This was true especially for largepeptides above 2000 m/z where the contribution of the fifth isotopicpeak of the ¹⁶O labelled peptide to the S₄ peak becomes significant.Calculation of mixed ¹⁶O¹⁸O incorporation was determined by thedifference in the experimental S₂ and theoretical S₂ (J₂) as apercentage of experimental S₄.

Protein abundance ratios were determined by averaging all identifiedpeptides of the same protein, even when the same protein was identifiedin more than one gel section. The data from each “normal” replicate wascombined with the inversed ratios from its respective “reverse”replicate providing an average ratio and standard error for each proteinin each biological replicate. Normalization of both the biologicalreplicates was then carried out similarly to that previously reported(34,35). Briefly the averaged ratio for each biological replicate wasmultiplied by a factor so that the geometric mean of the ratios wasequal to one.

Preparation and Analysis of ICAT Labelled Haem-Limited and Excess Cells

Protein labelling and separation were based on the geLC-MS/MS approach(Li et al., 2003) using the cleavable ICAT reagent (Applied Biosystems).Another proteomic approach has been taken in PCT/AU2007/000890 which isherein incorporated by reference. Protein was first precipitated usingTCA (16%) and solubilised with 6 M urea, 5 mM EDTA, 0.05% SDS and 50 mMTris-HCl pH 8.3. Protein concentration was determined using the BCAprotein reagent and adjusted to 1 mg/ml. 100 μg of protein from eachgrowth condition was individually reduced using 2 μL of 50 mMTris(2-carboxy-ethyl)phosphine hydrochloride for 1 h at 37° C. Reducedprotein from the haem-limitation growth condition was then alkylatedwith the ICAT_(heavy) reagent and protein from haem-excess growthcondition with the ICAT_(light) reagent. The two samples were thencombined and subjected to SDS-PAGE on a precast Novex 10% NUPAGE gel(Invitrogen). The gel was stained for 5 min using SimplyBlue™ SafeStain(Invitrogen) followed by destaining with water. The gel lane was thenexcised into 20 sections from the top of the gel to the dye front.

The excised sections were further diced into 1 mm³ cubes and in-geldigested overnight and extracted twice according to the above procedure.The pooled supernatant was dried under reduced vacuum to about 50 μLfollowed by mixing with 500 μL of affinity load buffer before loadingonto the affinity column as per manufacturer's instruction (AppliedBiosystems). Eluted peptides were dried and the biotin tag cleaved withneat TFA at 37° C. for 2 h followed by drying under reduced vacuum. Thedried samples were suspended in 35 μL of 5% acetonitrile in 0.1% TFA.

MS was carried out using an Esquire HCT ion trap mass spectrometer(Bruker Daltonics) coupled to an UltiMate Nano LC system (LCPackings—Dionex). Separation was achieved using a LC Packings reversedphase column (C18 PepMap100, 75 μm i.d.×15 cm, 3 μm, 100 Å), and elutedin 0.1% formic acid with the following acetonitrile gradient: 0-5 min(0%), 5-10 min (0-10%), 10-100 min (10-50%), 100-120 min (50-80%),120-130 min (80-100%).

The LC output was directly interfaced to the nanospray ion source. MSacquisitions were performed under an ion charge control of 100000 in them/z range of 300-1500 with maximum accumulation time of 100 ms. Whenusing GPF three additional m/z ranges (300-800, 700-1200 and 1100-1500)were used to select for precursor ions and each m/z range was carriedout in duplicate to increase the number of peptides identified. MS/MSacquisition was obtained over a mass range from 100-3000 m/z and wasperformed on up to 10 precursors for initial complete proteome analysisand 3 for ICAT analysis for the most intense multiply charged ions withan active exclusion time of 2 min.

Peak lists were generated using DataAnalysis 3.2 (Bruker Daltonics)using the Apex peak finder algorithm with a compound detection thresholdof 10000 and signal to noise threshold of 5. A global charge limitationof +2 and +3 were set for exported data. Protein identification wasachieved using the MASCOT search engine (MASCOT 2.1.02, Matrix Science)on MS/MS data queried against the P. gingivalis database obtained fromThe Institute for Genomic Research (TIGR) website (www.tigr.org). Thematched peptides were further evaluated using the following criteria, i)peptides with a probability based Mowse score corresponding to a p-valueof at most 0.05 were regarded as positively identified, where the scoreis −log×10(log(P)) and P is the probability that the observed match is arandom event ii) where only one peptide was used in the identificationof a specific protein and the MASCOT score was below 30, manualverification of the spectra was performed. To increase confidence in theidentification of ICAT-labelled proteins especially for those withsingle peptide hits, additional filters were applied as follows: i) theheavy and light peptides of an ICAT pair must have exhibited closelyeluting peaks as determined from their extracted ion chromatograms ii)for proteins with a single unique peptide, this peptide must have beenidentified more than once (e.g. in different SDS-PAGE fractions or inboth the light and heavy ICAT forms iii) if a single peptide did notmeet the criteria of (ii), the MASCOT score must have been ≧25, theexpectation value ≦0.01 and the MS/MS spectrum must have exhibited acontiguous series of ‘b’ or ‘y’-type ions with the intense ions beingaccounted. Determinations of false positives were as described above.

The ratio of isotopically heavy ¹³C to light ¹²C ICAT labelled peptideswas determined using a script from DataAnalysis (Bruker Daltonics) andverified manually based on measurement of the monoisotopic peakintensity (signal intensity and peak area) in a single MS spectrum. Theminimum ion count of parent ions used for quantification was 2000although >96% of both heavy and light precursor ions were >10000. In thecase of poorly resolved spectra, the ratio was determined from the areaof the reconstructed extracted ion chromatograms (EIC) of the parentions. Averages were calculated for multiple peptides derived from asingle parent protein and outliers were removed using the Grubb's testwith α=0.05.

The cellular localization of P. gingivalis proteins was predicted usingCELLO (http://cello.life.nctu.edu.tw (36)). Extracellular, outermembrane, inner membrane and periplasmic predictions were considered tobe from the envelope fraction.

The concentrations of short-chain fatty acids (SCFA) in cell-freeculture supernatants (uninoculated, haem-excess and haem-limited) weredetermined by capillary gas chromatography based on the derivatizationmethod of Richardson et al. (37).

The correlation coefficient (r) between both biological replicates wasevaluated using the Pearson correlation coefficient function fromMicrosoft Excel. The coefficient of variance (CV) was calculated by thestandard deviation of the peptide abundance ratios divided by the mean,expressed as a percentage.

Extraction of Nucleic Acids for Transcriptomic Analysis

RNA was extracted from 5 mL samples of P. gingivalis cells harvesteddirectly from the chemostat. To each sample 0.2 volumes of RNAStabilisation Reagent (5% v/v phenol in absolute ethanol) were added.Cells were pelleted by centrifugation (9000 g, 5 min, 25° C.),immediately frozen in liquid nitrogen and stored at −70° C. for laterprocessing. Frozen cells were suspended in 1 mL of TRIzol reagent(Invitrogen) per 1×10¹⁰ cells and then disrupted using Lysing Matrix Bglass beads (MP Biomedicals) and the Precellys 24 homogeniser (BertinTechnologies, France). The glass beads were removed by centrifugationand the RNA fraction purified according to the TRIzol manufacturer's(Invitrogen) protocol, except that ethanol (at a final concentration of35%) rather than isopropanol was added at the RNA precipitation stageand samples were then transferred to the spin-columns from the IllustraRNAspin Mini RNA Isolation kit (GE Healthcare). RNA was purifiedaccording to the manufacturer's instructions from the binding steponwards, including on-column DNAse treatment to remove any residual DNA.RNA integrity was determined using the Experion automatedelectrophoresis station (Bio-Rad).

Genomic DNA was extracted from P. gingivalis cells growing in continuousculture using the DNeasy Blood & Tissue Kit (Qiagen) in accordance withthe manufacturer's instructions.

Microarray Design, Hybridization and Analysis

Microarray slides were printed by the Australian Genome ResearchFacility and consisted of 1977 custom designed 60-mer oligonucleotideprobes for the predicted protein coding regions of the P. gingivalis W83genome including additional protein coding regions predicted by the LosAlamos National Laboratory Oralgen project. Microarray Sample Pool (MSP)control probes were included to aid intensity-dependent normalisation.The full complement of probes was printed 3 times per microarray slideonto Corning UltraGAPS coated slides.

Slides were hybridised using either heme-excess or heme-limited sampleslabelled with Cy3, combined with a universal genomic DNA referencelabelled with Cy5 (GE Lifesciences). cDNA was synthesized from 10 μg oftotal RNA using the SuperScript plus indirect cDNA labelling system(Invitrogen), with 5 μg of random hexamers (Invitrogen) for priming ofthe cDNA synthesis reaction. cDNA was labelled with Cy3 using theAmersham CyDye post-labelling reactive dye pack (GE Lifesciences) andpurified using the purification module of the Invitrogen labellingsystem. Cy5-dUTP labelled genomic cDNA was synthesized in a similarmanner from 400 ng of DNA, using the BioPrime Plus Array CGH IndirectGenomic Labelling System (Invitrogen). Prior to hybridisation,microarray slides were immersed for 1 h in blocking solution (35%formamide, 1% BSA, 0.1% SDS, 5×SSPE [1×SSPE is 150 mM NaCl, 10 mMNaH₂PO₄, 1 mM EDTA]) at 42° C. After blocking slides were briefly washedin H₂O followed by 99% ethanol and then dried by centrifugation.Labelled cDNAs were resuspended in 55 μL of hybridization buffer (35%formamide, 5×SSPE, 0.1% SDS, 0.1 mg mL⁻¹ Salmon Sperm DNA) denatured at95° C. for 5 min then applied to slides and covered with LifterSlips(Erie Scientific). Hybridisation was performed at 42° C. for 16 h.Following hybridisation slides were successively washed in 0.1% SDS plus2×SSC [1×SSC is 150 mM NaCl 15 mM sodium citrate] (5 min at 42° C., allfurther washes performed at room temperature), 0.1% SDS plus 0.1×SSC (10min), 0.1×SSC (4 washes, 1 min each), and then quickly immersing in0.01×SSC, then 99% ethanol and using centrifugation to dry the slides.

Slides were scanned using a GenePix 4000B microarray scanner and imagesanalysed using GenePix Pro 6.0 software (Molecular Devices). Threeslides were used for each treatment (heme-limitation or heme-excess)representing three biological replicates.

Image analysis was performed using the GenePix Pro 6.0 software(Molecular Devices), and “morph” background values were used as thebackground estimates in further analysis. To identify differentiallyexpressed genes the LIMMA software package was used with a cut off ofP<0.005. Within array normalisation was performed by fitting a globalloess curve through the MSP control spots and applying the curve to allother spots. The Benjamini Hochberg method was used to control the falsediscovery rate to correct for multiple testing.

Gene predictions were based on the P. gingvalis W83 genome annotationfrom the The Institute for Genomic Research (TIGR, www.tigr.org). Operonprediction was carried out from the Microbesonline website(http://microbesonline.org)

Response of P. gingivalis to Heme-Limitation as Determined Using DNAMicroarray Analysis

A DNA microarray analysis of the effect of heme-limited growth on P.gingivalis global gene expression was carried out under identical growthconditions employed for the proteomic analysis. Analysis of data fromthree biological replicates identified a total of 160 genes that showedstatistically significant differential regulation between heme-excessand heme-limitation, with the majority of these genes showing increasedlevels of expression under conditions of heme-limitation and only 8genes being down-regulated. Many of the up-regulated genes werepredicted to be in operons and the majority of these showed similarchanges in transcript levels (Table 3 and 5). There was broad agreementbetween the transcriptomic and proteomic data with a significantcorrelation between the two data sets where differential regulation uponheme-limitation was observed [Spearman's correlation 0.6364, p<0.05].However for some of the proteins showing differences in abundance fromthe proteomic analysis, the transcriptomic analysis of the correspondinggenes did not detect any statistically significant differences in theabundance of the mRNA. The microarray analyses tended to identify onlythose genes encoding proteins that had large changes in abundance asdetermined by the proteomic analysis (Tables 3 and 5). Where protein andtranscript from the same gene were found to be significantly regulatedby heme-limitation the majority showed the same direction of regulation.The exceptions were two gene products, PG0026 a CTD family putative cellsurface proteinase and PG2132 a fimbrillin (FimA). These proteinsdecreased in abundance in the proteomic analysis under heme-limitationbut were predicted to be up-regulated by the transcriptomic analysis.Both these proteins are cell surface located and it is quite possiblethat they are either released from the cell surface orpost-translationally modified which could preclude them from beingidentified as up-regulated in the proteomic analysis.

Susceptibility of P. gingivalis to Frd Inhibiting Agents

The effect of Frd inhibiting agents on P. gingivalis was carried out inliquid cultures. Briefly W50 was cultured in 200 mL BHI medium until ODof 0.6 (˜2.9×10⁸ cfu/mL). The cells were then resuspended in freshgrowth medium to a final concentration of 2.5×10⁷ cfu/mL. Oxantelpamonate, morantel citrate and thiabendazole (Sigma) were dissolved inDMSO to achieve stock concentrations of 250 mM. 4 μL of the testsolution was then mixed with 196 μL of cell suspension and transferredinto 96 well flat bottom plates followed by incubation at 37° C. underanaerobic conditions and monitored hourly over a 50 h period bymeasuring the optical density of the culture at 620 nm using an iEMSmicroplate reader (Labsystems OY Research Technologies Division). Meangeneration times of P. gingivalis in the presence of differentinhibiting agents were calculated by dividing the doubling time[(Log₁₀N_(t)−Log₁₀N₀)/Log₁₀2] by the time (N_(t)−N₀) where N_(t) and N₀are cells population at time t and time zero, respectively.

Effects of Frd Inhibiting Agents on P. gingivalis Biofilm

P. gingivalis biofilm formation over 48 h in a static 96 well model wasdetermined as described previously. Briefly P. gingivalis ATCC 33277cells were resuspended to a final cell density of 2.5×10⁷ before mixingwith the test substances followed by transferring into 96 well flatbottom plates and incubated anaerobically at 37° C. Assessment of thebiofilm mass was carried out at 24 h and 48 h by washing the cells twicewith 250 μL of ultra pure water to remove loosely adhered cells followedby drying at 37° C. for 3 h. The dried biofilm was then stained in asolution of 0.1% crystal violet for 15 min and washed 2 times with 250μL ultra pure water. The crystal violet stain was then dissolved fromthe biofilm using a solution of 80% ethanol and 20% acetone for 2 minthrough repeated pipetting before transferring to a new 96 well platefor measurement of the optical density at 620 nm.

Flowcell Biofilm Culture and CSLM Analysis

The biofilm culture of P. gingivalis ATCC 33277 in flow cells wassimilar to that previously described with several modifications. A3-channel flow cell system (Stovall Life Science, USA) was set up in ananaerobic chamber (MK3 Anaerobic workstation; Don Whitley ScientificLtd.) and was modified with silicon pump tubing (Gilson, France) andstopcocks for inoculation, testing and staining of the bacterialbiofilms. All parts were assembled and 0.5% sodium hypochlorite waspumped into the system and left overnight to sterilise the system.Sterile water (200 mL) was then used to flush the system before growthmedium addition. The system was inoculated with 1 mL of an exponentiallygrowing P. gingivalis diluted to 0.1 OD₆₀₀. The system was incubated for1 h prior to constant flow (0.2 mL/min) of 5× diluted BHI (Oxoid)supplemented with 0.1 g/L cysteine, 1 mg/L heamin and 1 mg/L vitamin K.After 18 h, 1 mL of 125 μM or 12.5 μM of Oxantel or sterile water wasinjected into each channel of the system and incubated for 30 min. Theflow of medium was resumed for another 10 min to wash off any unboundcells due to testing. BacLight stain (Molecular Probes) was then used tostain the biofilm in situ (see below).

Confocal laser scanning microscopy (CLSM) of the bacterial biofilms wascarried out on a Meta 510 Confocal Microscope with an inverted stage(Zeiss). Horizontal (xy) optodigital sections, each 2 μm thick over theentire thickness of the biofilm (z) were imaged using a 63× objective at512×512 pixel (0.28 μm per pixel), with each frame at 143.86 μm(x)×143.86 μm (y). To determine reproducibility across the biofilm 5images at random positions from each of two biological replicates wereobtained at wavelengths of 488 nm and 568 nm for each channel. Allimages obtained were analysed using COMSTAT software. Microcolonies weredefined as cluster of cells with >500 pixel counts.

Viability of Cells Dispersed by Oxantel Treatment

To test the viability of cells dispersed by Oxantel treatment, a staticbiofilm assay was performed as described above but with slightmodifications. Briefly P. gingivalis (ATCC 33277) was allowed to formbiofilm in 24 well microplates after 18 h incubation. The free floatingplanktonic cells were first removed and the biofilm washed once withPBS. 1 mL of 125 uM or 12.5 uM of Oxantel or sterile water (positivecontrol) was added to each well and incubated for 30 min. The number ofdispersed P. gingivalis cells that are still viable was determined bycultural analysis on horse blood agar plates after serial dilution inBHI.

Statistical Analysis

The correlation coefficient (r) between both biological replicates wasevaluated using the Pearson correlation coefficient function fromMicrosoft Excel. The coefficient of variance (CV) was calculated by thestandard deviation of the peptide abundance ratios divided by the mean,expressed as a percentage.

Continuous Culture and Biofilm Formation

P. gingivalis W50 was cultured in continuous culture over a 40 dayperiod during which the cell density of the culture remained constantafter the first 10 days with an OD₆₅₀ of 2.69±0.21 and 2.80±0.52 forbiological replicates 1 and 2 respectively. This equates to a celldensity of ˜3 mg cellular dry weight/mL. Over this time period a biofilmof P. gingivalis cells developed on the vertical glass wall of thefermenter vessel. This biofilm was ˜2 mm thick at the time of harvest.

Validation of ¹⁶O/¹⁸O Quantification Method Using BSA

To determine the accuracy and reproducibility of the ¹⁶O/¹⁸Oquantification method, known amounts of BSA were loaded onto adjacentgel lanes to give ratios of 1:1, 1:2, 1:5 and 10:1 (FIG. 1B). The bandswere subjected to in-gel tryptic digestion in the presence of either H₂¹⁶O or H₂ ¹⁸O, mixed and then analyzed by LC MALDI-MS/MS. A typical setof spectra for a single BSA tryptic peptide across the four ratios showsthe preferential incorporation of two ¹⁸O atoms, which is seen mostclearly by the predominance of the +4 Da peak in the 10:1 BSA ratio, andby the almost symmetrical doublet in the 1:1 spectrum, simplifying bothquantification and identification (FIG. 1A). The average incorporationof a single ¹⁸O atom was estimated to be <7% based on the 1:1 labelling(Supplementary Table). The calculated average ratios for all identifiedBSA peptides were 0.98±0.12, 2.22±0.26, 4.90±0.75 and 10.74±2.04 forratios of 1:1 (triplicate), 2:1 (and 1:2), 1:5 and 10:1, respectivelyindicating a good dynamic range, high accuracy of ±2-11% and a low CVranging from 11.75% to 18.95% (Table 1). The reproducible accuracy ofthe 1:1 mixture (performed in triplicate) implies that labelling biaswas very low. This was further confirmed by comparing normal and reverselabelled BSA at a 2:1 ratio, using only peptides that were identified inboth experiments. The normal ratio was determined to be 2.11±0.33 whilethe reverse was 2.30±0.20 (Table 1).

Experimental Design for Quantitative Analysis of Biofilm and PlanktonicSamples

The design of this study involved the use of two biological replicates,that is two independent continuous cultures, each one split into abiofilm sample obtained from the walls of the vessel, and a planktonicsample obtained from the fluid contents of the vessel. Two technicalreplicates for each biological replicate were performed, and although wehad established that there was no significant labelling bias with BSA,we chose to utilize the reverse labelling strategy as there is a lack of¹⁶O/¹⁸O labelling validation studies that have been conducted on complexbiological samples (30). Therefore in total there were four experiments,each consisting of 10 LC-MALDI MS/MS runs stemming from 2×10 gelsegments.

FIG. 2 shows typical MS and MS/MS spectra of two normal and reverselabelled peptides from the biofilm/planktonic samples illustrating thetypical reverse labelling pattern. As with the BSA data, it could beseen that there was a high level of double ¹⁸O incorporation with theaverage mixed incorporation calculated to be <15% for all peptides,confirming that the ¹⁶R O/¹⁸O proteolytic labelling method was alsoeffective with complex samples (data not shown). The predominance ofdoubly labelled peptides was further confirmed by the relatively fewMascot hits to the +2 Da species. MS/MS spectra of the heavy labelledpeptides further revealed the expected +4 Da shifts in the Y ions (FIG.2).

Correlation Between Technical Replicates

To compare technical replicates of the biological data, the Log₁₀transformed protein abundance ratios of each pair of normal and reverselabelled experiments were plotted against each other (FIG. 3). Linearregression of these plots indicated that each pair is highly correlatedwith R² values of 0.92 and 0.82 for biological replicate 1 and 2,respectively. The slope of each linear fit was also similar to theexpected value of 1.0 at 0.97 and 0.93 for biological replicate 1 and 2,respectively indicating no labelling bias between the technicalreplicates (FIG. 3). The protein abundance ratios from the technicalreplicates were averaged to give a single ratio for each biologicalreplicate.

Correlation of Biological Replicates

Before comparing the average data for the two biological replicates, theprotein abundance ratios of each biological replicate were normalized togive an average mean ratio of 1.0. A plot of the normalized proteinabundance ratios from both the biological replicates exhibits aGaussian-like distribution closely centered at zero (FIG. 4A) similar tothat described by others (40,41). There was a significant positivecorrelation between the two biological replicates (Pearson's correlationcoefficient r=0.701, p<0.0001) indicating that the growth of thebiofilm/planktonic cultures and all downstream processing of the samplescould be reproduced to a satisfactory level. To determine which proteinswere consistently regulated in the two biological replicates, a simpleranking chart was constructed where proteins were divided into 6 groups(A-F) according to their abundance ratio and then ranked 1-6 accordingto group-based correlation, with those ranked 1 having the highestsimilarity when a protein from both biological replicates fell withinthe same group (FIG. 4B). Using the ranking chart, we were able todetermine that 34 out of 81 (42%) of the proteins identified from bothreplicates were ranked number one, considerably higher than the valueexpected for a random correlation which would be 17% (or ⅙). Themajority of the remaining proteins were ranked number two, and thereforein total, 70 proteins (86.4%) were considered to be similarly regulatedbetween the two experiments (ranked 1 or 2; Table 2).

Based on the measured standard deviation (±0.26) of the 2:1 BSAlabelling experiment (Table 1), protein abundance changes were deemed tobe biologically significant when they differed from 1.0 by >3 standarddeviations (either >1.78 or <0.56) (18,42). Using this criteria, theabundance of 47 out of the 81 proteins identified in both replicateswere significantly changed (based on the average ratios), and of these,42 were ranked either 1 or 2 (Table 2). Of the 42 proteins ranked 1 and2, 24 had significantly increased in abundance and 18 had decreased inabundance.

Enzymes of Metabolic Pathways Showing Co-Ordinated Regulation

Twenty proteins involved in the glutamate/aspartate catabolism wereidentified in the haem-limited vs haem-excess study using ICAT labellingstrategies (Table 3). Of those, enzymes catalyzing six of the eightsteps directly involved in the catabolism of glutamate to butyrate wereidentified and found to have increased 1.8 to 4 fold underhaem-limitation (FIG. 6, Table 3). Although the other two catalyticenzymes (PG0690, 4-hydroxybutyrate CoA-transferase and PG1066,butyrate-acetoacetate CoA-transferase) were not detected using ICAT,they were found to be present in a separate qualitative study atcomparable high ion intensities to those proteins reported in Table 3and belong to operons shown to be upregulated. On the other hand, theeffect of haem-limitation on the abundances of the enzymes of theaspartate catabolic pathway was mixed, with the enzymes catalyzing thebreakdown of aspartate to oxaloacetate in the oxidative degradationpathway being unchanged and the enzymes involved in the conversion ofpyruvate to acetate showing an increase of 2 to 4.4 fold.

The abundance of two iron containing fumarate reductase enzymes, FrdA(PG1615) and FrdB (PG1614) that together catalyse the conversion offumarate to succinate via the reductive pathway from aspartate, wassignificantly reduced in cells cultured in haem-limitation (FIG. 6,Table 3). These two proteins, that are encoded in an operon (Baughn etal., 2003), show similar changes in abundance in response tohaem-limitation (FrdA L/E=0.35; FrdB L/E=0.25).

Analysis of Organic Acid End Products

The amounts of acetate, butyrate and propionate in the spent culturemedium of P. gingivalis grown under haem limitation were 13.09±1.82,7.77±0.40 and 0.71±0.05 mmole/g cellular dry weight, respectively.Levels of acetate, butyrate and propionate in the spent culture mediumof P. gingivalis grown in haem excess were 6.00±0.36, 6.51±0.04 and0.66±0.07 mmole/g cellular dry weight, respectively.

Effects of Frd Inhibiting Agents on P. gingivalis Growth

The effect of different concentrations of the three anthelminticsoxantel, morantel and thiabendazole on the growth of P. gingivalis W50over 50 hrs was shown in FIGS. 7, 8 and 9. The effect of DMSO on growthwas negligible as seen in the similar MGT of P. gingivalis with previousreported studies and the W50 alone (43,44). The most profound effect ofthese three inhibiting agents on the growth of P. gingivalis is oxantel(FIG. 7). From the growth curves, it is clear that there is positiveinhibition of oxantel on the growth of P. gingivalis at concentrationsof more than 15 μM. Minimal inhibitory concentrations (MIC) of oxantelwas determined as previously described (45) to be 112 μM. There was alsosignificantly correlation of increasing concentration of oxantel withhigher MGT as seen for subMICs of oxantel (FIG. 7A). The bactericidaleffect of morantel was comparably lower than oxantel with MIC of ˜3 mMbut still shows significant inhibitory effects at subMICs (FIG. 8).Thiabendazole appears not to have very significant inhibitory effects onthe growth of P. gingivalis and apparently requiring more than 1 mM forslight inhibitory effects on the growth (FIG. 9). In conclusion, theinhibitory effects of the different Frd inhibiting agents were estimatedto be in the order of oxantel>>morantel>thiabendazole.

Effects of Sub Minimal Inhibitory Concentrations of Oxantel on BiofilmFormation

Oxantel, having the most profound effects on P. gingivalis growth wasused to study its effects on biofilm formation In the biofilm test, P.gingivalis strain ATCC 33277 was used in place of W50 since the latterforms biofilms only poorly under most circumstances. As the growthinhibitory effect of oxantel on strain ATCC 33277 is similar to W50 inplanktonic assays at 125 μM (FIG. 7B), it therefore represents a goodmodel to study the effects of oxantel on biofilm formation. Oxantel atsub minimal inhibitory concentrations (SubMIC) of as low as 0.1 μMsignificantly reduced the biofilm mass at 24 h (FIG. 10A) althoughconcentrations of 3.9 μM or higher were necessary to have an inhibitoryeffect on the biofilm mass at 48 h (FIG. 10B).

Effect of Oxantel on Biofilm Dispersal

To more closely study the effects of SubMIC of Oxantel, on P. gingivalisbiofilms a flowcell culture system was used. There was a significantreduction in the biofilm depth and size of microcolonies when the maturebiofilm was treated with Oxantel (P<0.01) whereas there was nosignificant difference in the number of microcolonies between thecontrol and treated samples (FIGS. 11-13, Table 6).

P. gingivalis cells released from the biofilm remained viable especiallyfor the 12.5 μM Oxantel treated biofilm (FIG. 14). The non treatedcontrol cells appeared more resistant to dispersal as compared toOxantel treated cells. The number of recovered cells from the biofilm isalso consistent with that seen under the CLSM (FIGS. 11-13) withsignificantly higher number of cells in the control sample.

The above results illustrate the changes in protein abundance that occurwhen planktonic P. gingivalis cells adhere to a solid surface and growas part of a mature monospecies biofilm. It is the first comparativestudy of bacterial biofilm versus planktonic growth to utilize eitherthe geLC MS approach of Gygi's group (46) or the ¹⁶O/¹⁸O proteolyticlabelling method to determine changes in protein abundances as all othersuch studies published to date have utilized 2D gel electrophoresisbased methods (10-12). A two technical replicate and two biologicalreplicate 160/¹⁸O reverse labelling approach was successfully employedto quantitate and validate the changes in protein abundance.

Continuous Culture of P. gingivalis

In this study P. gingivalis W50 was cultured in continuous culture asopposed to the more traditional methodology of batch culture. Batchculture introduces a large range and degree of variation into bacterialanalyses due to interbatch variables such as: size and viability of theinoculum, exact growth stage of the bacterium when harvested, levels ofavailable nutrients in the medium and redox potential of the medium,amongst other factors. In continuous culture the bacterium is grown formany generations under strictly controlled conditions that includegrowth rate, cell density, nutrient concentrations, temperature, pH andredox potential. (44,47,48). A previous study has demonstrated a highlevel of reproducibility of Saccharomyces cerevisiae transcriptomicanalyses continuously cultured in chemostats in different laboratories(49). Furthermore in our study the growth of both biofilm and planktoniccells was carried out in a single fermentation vessel, reducingvariability as compared to separate cultivations. The consistent changesin P. gingivalis cell envelope protein abundances between biologicalreplicates of 86.4% of the identified proteins (ranked 1 and 2) seen inthis study illustrate the applicability of the continuous culture systemand the ¹⁶O/¹⁸O proteolytic labelling strategy to the analysis of theeffect of biofilm growth on the P. gingivalis proteome.

Efficiency of ¹⁸O Labelling

The basic proteomic method employed in this study was the geLC MS method(46,50) due to the high resolution and solubility of membrane proteinsthat the SDS-PAGE method affords. This method was combined with a single¹⁸O labelling reaction during the in-gel digestion procedure similar tothat described by others (26-29). Efficient labelling should result inthe incorporation of two ¹⁸O atoms into the C-terminus of each peptideand should be resistant to back-exchange with ¹⁶O. This was found to bethe case in our study with BSA where the level of single ¹⁸O atomincorporation was estimated to be <7% and the mean ratios obtained forvarious BSA experiments were found not to significantly favor ¹⁶O(Table 1) suggesting that back exchange with normal water was not aproblem. Similar results were also obtained for the biological samples.A crucial step for efficient ¹⁸O labelling was the need for the completeremoval of the natural H₂ ¹⁶O followed by resolubilization of theprotein in H₂ ¹⁸O before tryptic digestion employing a“single-digestion” method. Although a number of studies have used a“double digestion” method (51,52), the single digestion method has theadvantage of giving a higher efficiency of ¹⁸O labelling as in thedouble digestion method some tryptic peptides were unable to exchangeeither of their C-terminal ¹⁶O atoms for an ¹⁸O atom after the initialdigestion (53). We further utilized an in-gel digestion method where theprotein is retained in the gel matrix during the initial dehydrationstep using organic solvents as in any standard in-gel digestionprotocol. Complete removal of any trace natural H₂ ¹⁶O was achievedthrough lyophilization by centrifugation under vacuum while the proteinwas still within the gel matrix to prevent further adsorptive lossesduring the initial lyophylization step. Rehydration and in-gel digestionwas carried out in H₂ ¹⁸O containing a large excess of trypsin which wasalso reconstituted in H₂ ¹⁸O. During the digestion procedure, trypticpeptides liberated from the gel after the incorporation of the first ¹⁸Oatom can undergo the second carbonyl oxygen exchange process mediated bythe excess trypsin. This should promote the replacement of the secondcarbonyl oxygen since peptides liberated would have higher solubilitythan proteins thereby resulting in a higher level of doubly ¹⁸O labelledtryptic peptides (FIGS. 1 and 2; (54)). In order to prevent backexchange with normal water, trypsin was deactivated by boiling which hasbeen previously shown to be effective (51,54). In addition, the dried,deactivated mix was only resuspended and mixed immediately prior toinjection onto a nanoLC to minimize spontaneous exchange, although thisspontaneous exchange has been shown to be low (15,40).

Reverse Labelling

In the case of stable isotope labelling and quantification using MS,errors are potentially introduced during the labelling and ionizationprocess. These errors include the potential different affinity of thelabel and the possible suppression effect of the heavy or light labelledpeptides during the MALDI process (13,55). Traditional technicalreplicates which involve repeating the same labelling could result in anuncorrected bias towards a particular label or increased random error ofspecific peptides due to contaminating peaks. Our normal and reverselabelled technical replicates demonstrated a high degree of correlationwith scatter plot gradients of 0.97 (R²=0.92) and 0.93 (R²=0.82) forbiological replicates 1 and 2, respectively (FIG. 3) which is close tothe expected ratio of 1.0 for no labelling bias. These gradients alsoindicate that the method was reproducible with respect to proteinestimation, gel loading, gel excision and in-gel digestion. The lack ofbias suggests normalization routines like dye swap or LOWESS datanormalization routinely used in microarray experiments (35) might beunnecessary. However samples that are considerably more complex than thebacterial cell envelopes used in this study may still require reverselabelling validation as when one considers the influence of minorcontaminating peptides on the calculation of the 18O/¹⁶O ratios and theneed to verify peptides with extreme changes. The reverse-label designin addition to providing an estimate and means for correcting systematicerrors had the further benefit of allowing both the heavy and lightlabelled peptides to be readily identified since the MS/MS acquisitionmethod selected only the most intense peptide in each heavy/light pairto fragment. In this way the possibility of incorrect assignment isreduced. To our knowledge, this is the first report of reverse ¹⁶O/18Olabelling in a complex biological sample other than the recentquantitation of seventeen cytochrome P450 proteins (26,30).

Biofilm vs Planktonic Culture

We have demonstrated a strong positive correlation between thebiological replicates (r=0.701, p<0.0001) indicating that there wasreproducibility in biofilm formation and development. This was also seenby the finding that 70 out of 81 quantifiable proteins were observed toexhibit similar ratios in both biological replicates (Table 2, ranked 1or 2). More than three quarters of the P. gingivalis proteins identifiedin this study were identified by >2 unique peptides, further increasingthe confidence of identification and quantification of this labellingprocedure. Of the 81 proteins consistently identified from bothbiological replicates, 47 significantly changed in abundance from theplanktonic to biofilm state. The change in abundance of a percentage ofthe detected proteome, especially in the cell envelope, is consistentwith other studies on biofilm forming bacteria such as Pseudomonasaeruginosa, where over 50% of the detected proteome was shown to exhibitsignificant changes in abundance between planktonic and mature biofilmgrowth phases. (12). We further observed a wide range of responses inthe cell envelope proteome of P. gingivalis to growth as a biofilm. Anumber of proteins previously demonstrated to be altered in abundance inresponse to biofilm culture were also found to have changed in abundancein our study. Remarkably some proteins were observed to have changed inabundance by up to fivefold (Table 2) suggesting some major shifts inthe proteome in response to biofilm culture.

Metabolism

The principal source of energy for P. gingivalis is derived from thefermentation of amino acids which are obtained in peptide form by theproteolytic hydrolysis of host proteins (47,80,81). The major catabolicpathways of P. gingivalis are the fermentation of glutamate andaspartate where glutamate is metabolized to butyrate, propionate andammonia, and aspartate metabolized to butyrate, propionate, acetate andammonia (FIG. 6). Previous reports have shown that P. gingivalispreferentially utilizes aspartate/asparagine, glutamate/glutamine,threonine, serine, leucine and valine from the culture medium(47,81,82).

Two P. gingivalis proteins involved in glutamate catabolism, PG1076(L/E=1.8) and PG1078 (L/E=2.0) significantly increased in abundanceduring haem-limitation. These proteins are encoded by genes arranged ina predicted large operon of 15 genes. Upstream of these genes are twogenes encoding a hypothetical protein and a conserved hypotheticalprotein whose abundance also increased during haem-limitation (PG1067,L/E=2.4 and PG1068, UE=1.7, respectively). Analysis of this large operonfurther revealed the presence of a putative Fur consensus binding regioncharacteristic of many iron-regulated genes (83), which suggests thatexpression might be controlled by iron availability. Although weexpected the fold change of all encoded proteins in an operon to be thesame, this is not necessarily the case in all instances as the level oftranscript sometimes does not correlate with the protein levels (84).This could be due to posttranslational modifications or stability of thetranscript, allowing a substantial regulation of cellular events tooccur at the protein level with no apparent change in the mRNAabundance.

The conversion of fumarate to succinate via the pathway from aspartateis catalysed by a heterotrimeric succinate-quinone oxidoreductase (SQOR)complex consisting of two cytoplasmic enzymes FrdA (1615) and FrdB(1614) and a transmembrane FrdC (1616). The abundance of the twocytoplasmic fumarate reductase enzymes, FrdA (PG1615) and FrdB (PG1614)was significantly reduced in cells cultured in haem-limitation (3 and 4fold, respectively) and biofilm growth (17 and 5.9 fold, respectively).These two proteins, that are encoded in an operon (85), show similarchanges in abundance in response to haem-limitation (FrdA L/E=0.35; FrdBL/E=0.25) and biofilm growth (FrdA B/P=0.06; FrdB B/P=0.17). Previousstudies in Bacteroides fragilis have suggested that haem is required forthe synthesis of the cytochrome-b-dependent Frd complex (86). It istherefore not surprising to see lower levels of Frd duringhaem-limitation growth conditions in P. gingivalis considering that itis unable to synthesize PPIX de novo. Growth studies of both B. fragilisand P. gingivalis have shown that they require haem for growth and thatthis requirement can be partially substituted by exogenous succinate(87,88). This observation was confirmed using B. fragilis Frd deficientmutants whose growth was not stimulated by haem but was stimulated byaddition of succinate (85). Molar growth yield studies further showedthat the B. fragilis Frd deficient mutants have a similar ATP yield tothat of a haem-restricted wild-type strain. During optimum growth,succinate is converted to succinyl-CoA either for entry into energyproducing pathways or for biosynthesis of essential amino acids (lysineand methionine). These studies demonstrate the importance of theconversion of aspartate to succinate for balanced growth. Underhaem-excess conditions a portion of the aspartate catabolized by P.gingivalis is initially reduced via the fumarate reductase enzymes (FrdAand FrdB) to succinate and then catabolized via the glutamate pathway toproduce butyrate (FIG. 6). The 3-4 fold decrease in abundance of thesefumarate reductase enzymes during haem-limitation indicates that less ofthe aspartate would enter the glutamate catabolic pathway and as aconsequence of this most of the aspartate catabolized would be convertedvia the oxidative pathway to acetate (FIG. 6). To test this hypothesiswe carried out organic acid analysis on the spent culture media from P.gingivalis grown in continuous culture. This showed there was a two-foldhigher level of acetate produced under haem-limitation (13.09±1.82mmole/g cellular dry weight) compared with the level produced underhaem-excess (6.00±0.36 mmole/g cellular dry weight), whilst the levelsof the other major end products, butyrate and propionate were similarunder both growth conditions. This is consistent with our hypothesis ofa shift in the pathway used for aspartate fermentation. The increase inthe abundance of the enzymes that catalyse the conversion of pyruvate toacetate (Acetate kinase PG1081, Phosphotransacetylase PG1082 andPyruvate ferredoxin PG0548) is also consistent with the increasedamounts of acetate found in the spent culture medium (Table 2; FIG. 6).

These results thus prompted us to investigate into ways to control thebacterium through inhibition of this delicate metabolic regulatorypathway.

Effects of Fumarate Reductase Inhibiting Agents on Growth

We have shown a 17.0 and 5.9 fold reduction in the abundance of the Frdcomplex (FrdA and FrdB, respectively) during biofilm growth of P.gingivalis which is even greater than the 3 and 4 fold reductions inFrdA and FrdB during haem-limitation growth. The consistent lowerabundance of the Frd complex correlates with the diminished growth ofthe bacterium associated with the limitation of haem during both biofilmand haem-limited growth conditions. Smith et al. (89) have previouslydemonstrated that Frd activities of Campylobacter spp to be higher incultures growing exponentially but decreased as it entered thestationary phase. It therefore suggests that Frd activity limits growthrate which highlights it to be an attractive new therapeutic target.Fumarate respiration is the most widespread type of anaerobicrespiration and is the only metabolic intermediate known to serve as anelectron acceptor yielding ˜0.5 ATP/electron to form succinate as theend product (90). Shah and William (91) reported that P. gingivalisproduced succinate from aspartate and Takahashi et al. (81) proposedthat the succinate produced was converted to succinyl-CoA which was thenconverted into butyrate or propionate.

Anthelmintics usually used to cure helminthic infection in animals andhumans were demonstrated to have inhibitory and bacteriocidal effectsagainst Helicobacter pylori and Campylobacter jejuni (89,94). One ofthese drugs, oxantel has been shown to be an inhibitor of the fumaratereductase enzyme in H. pylori and C. jejuni presumably on thehydrophilic subunits of the Frd complex through unknown mechanisms(94-96).

Interestingly not all anaerobic bacteria possess Frd and some bacteriathat possess Frd have alternative biochemical pathways for survival whenFrd is inhibited (97,98). Therefore the discovery that the viability ofP. gingivalis is severely affected in the presence of Frd inhibitingagents (FIG. 7-10) suggests the enzyme being absolute essential forgrowth and ATP contribution from the aspartate pathway could play acrucial role in the survival of P. gingivalis. As the Frd complex isabsent in humans and other animals (92,93), Frd inhibiting agent providea target against diseases caused by pathogens, especially those havingan essential requirement for Frd.

Effects of Fumarate Reductase Inhibiting Agents on Biofilm Formation

The following illustrates the effect of Frd inhibiting agents on theability of P. gingivalis to form biofilms. The reduction of biofilm massat subMIC oxantel concentrations is very interesting as it suggeststhere is a minimal amount of Frd or energy required for optimum biofilmformation.

The partial inhibition of Frd by subMIC concentrations of Frd inhibitingagents could be translated as similar signals such in a nutrient poorenvironment. For example carbon regulated biofilm formation is welldocumented in a number of bacteria including Pseudomonas aeruginosa andE. coli and us mediated by transcriptional regulators such as RpoS, Crcand CsrA in during nutrient limitation (99-101). In E. coli the csrAgene encodes a global regulatory protein, CsrA (carbon storageregulator) which represses certain metabolic pathways such as glycogensynthesis and gluconeogenesis (101,102). Disruption of csrA in E. coliresulted in enhanced biofilm formation (101,103) and interestingly,activation of the CsrA homologue in Salmonella enterica serovarTyphimurium resulted in increased epithelial cell invasion due to theeffects of CsrA on other targets (104,105). It is therefore verytempting to speculate that haem-limited P. gingivalis are less likely toform biofilms due to the lower ATP levels as a result of reduced Frdactivity as such host cell invasion proteins including internalins areupregulated to promote escape into epithelial cells till end of nutrientdeprivation.

There is a higher abundance of the glycolytic enzyme glyceraldehyde3-phosphate dehydrogenase (GAPDH) during the biofilm state compared tothe planktonic which is consistent with previous results obtained forListeria monocytogenes and Pseudomonas aeruginosa (12,106). AlthoughGAPDH is classified as a tetrameric NAD-binding enzyme involved inglycolysis and gluconeogenesis, there have been numerous reports of thisprotein being multifunctional and when expressed at the cell surface ofGram-positive bacteria, it appeared to be involved in binding ofplasmin, plasminogen and transferrin (107,108). Interestinglycoaggregation between Streptococcus oralis and P. gingivalis 33277 hasbeen shown to be mediated by the interaction of P. gingivalis fimbriaeand S. oralis GAPDH (109). The exact role, if any, of GAPDH in substratebinding in P. gingivalis however remains to be answered.

Biofilm Formation

There was a significantly higher abundance of the universal stressprotein (UspA) in the planktonic cells as compared to the biofilm cells.The production of UspA) in various bacteria was found to be stimulatedby a large variety of conditions, such as entry into stationary phase,starvation of certain nutrients, oxidants and other stimulants(110,111). The increased abundance in planktonic phase cells isconsistent with the fact that P. gingivalis has evolved to grow as partof a biofilm and that planktonic phases are likely to be more stressful.Expression of UspA in P. gingivalis is thought to be related to biofilmformation as inactivation of uspA resulted in the attenuation of earlybiofilm formation by planktonic cells (112). In this study the biofilmhas been established and reached maturation, it therefore appears tohave lesser need for UspA as compared to free floating planktonic cells.

A homologue of the internalin family protein InIJ (PG0350) was observedto be higher in abundance during the biofilm state. PG0350 has beenshown to be important for biofilm formation in P. gingivalis 33277 asgene inactivation resulted in reduced biofilm formation (39). Higherlevels of PG0350 in the biofilm could suggest that this protein might berequired not just for initial biofilm formation but acts an adhesin thatbinds P. gingivalis to each other or extracellular substrates within thebiofilm.

Proteins with Unknown Functions

The largest group of proteins identified in this study was 41 proteinswith unknown functions including four proteins that were identified forthe first time in this study (Table 2). Of the 41 proteins identified,37 were predicted to be from the cell envelope and within this group 17proteins show significant changes between the biofilm and planktoniccells. The majority of these proteins have homology to GenBank proteinswith defined names but not well-defined functions. Of particularinterest are several proteins that were consistently found tosubstantially increase in abundance in the biofilm state, namely PG0181,PG0613, PG1304, PG2167 and PG2168.

The above results represent a large scale validation of the ¹⁶O/¹⁸Oproteolytic labelling method as applied to a complex mixture, and arethe first to use this approach for the comparison of bacterial biofilmand planktonic growth states. A substantial number of proteins with avariety of functions were found to consistently increase or decrease inabundance in the biofilm cells, indicating how the cells adapt tobiofilm conditions and also providing potential targets for biofilmcontrol strategies.

EXAMPLES

To help illustrate compositions embodying an aspect of the inventiondirected to treatment, the following sample formulations are provided.

The following is an example of a toothpaste formulation.

Ingredient % w/w Dicalcium phosphate dihydrate 50.0 Glycerol 20.0 Sodiumcarboxymethyl cellulose 1.0 Sodium lauryl sulphate 1.5 Sodium lauroylsarconisate 0.5 Flavour 1.0 Sodium saccharin 0.1 Chlorhexidine gluconate0.01 Dextranase 0.01 Biofilm inhibitor (Oxantel pamoate) 0.2 Waterbalance

The following is an example of a toothpaste formulation.

Ingredient % w/w Dicalcium phosphate dihydrate 50.0 Sorbitol 10.0Glycerol 10.0 Sodium carboxymethyl cellulose 1.0 Sodium lauryl sulphate1.5 Sodium lauroyl sarconisate 0.5 Flavour 1.0 Sodium saccharin 0.1Sodium monofluorophosphate 0.3 Chlorhexidine gluconate 0.01 Dextranase0.01 Biofilm inhibitor (Oxantel pamoate) 0.2 Water balance

The following is an example of a toothpaste formulation.

Ingredient % w/w Dicalcium phosphate dihydrate 50.0 Sorbitol 10.0Glycerol 10.0 Sodium carboxymethyl cellulose 1.0 Lauroyl diethanolamide1.0 Sucrose monolaurate 2.0 Flavour 1.0 Sodium saccharin 0.1 Sodiummonofluorophosphate 0.3 Chlorhexidine gluconate 0.01 Dextranase 0.01Biofilm inhibitor (Oxantel pamoate) 0.1 Water balance

The following is an example of a toothpaste formulation.

Ingredient % w/w Sorbitol 22.0 Irish moss 1.0 Sodium Hydroxide (50%) 1.0Gantrez 19.0 Water (deionised) 2.69 Sodium Monofluorophosphate 0.76Sodium saccharine 0.3 Pyrophosphate 2.0 Hydrated alumina 48.0 Flavouroil 0.95 Biofilm inhibitor (Oxantel pamoate) 0.3 sodium lauryl sulphate2.00

The following is an example of a liquid toothpaste formulation.

Ingredient % w/w Sodium polyacrylate 50.0 Sorbitol 10.0 Glycerol 20.0Flavour 1.0 Sodium saccharin 0.1 Sodium monofluorophosphate 0.3Chlorhexidine gluconate 0.01 Ethanol 3.0 Biofilm inhibitor (Oxantelpamoate) 0.2 Linolic acid 0.05 Water balance

The following is an example of a mouthwash formulation.

Ingredient % w/w Ethanol 20.0 Flavour 1.0 Sodium saccharin 0.1 Sodiummonofluorophosphate 0.3 Chlorhexidine gluconate 0.01 Lauroyldiethanolamide 0.3 Biofilm inhibitor (Oxantel pamoate) 0.2 Water balance

The following is an example of a mouthwash formulation.

Ingredient % w/w Gantrez ® S-97 2.5 Glycerine 10.0 Flavour oil 0.4Sodium monofluorophosphate 0.05 Chlorhexidine gluconate 0.01 Lauroyldiethanolamide 0.2 Biofilm inhibitor (Oxantel pamoate) 0.3 Water balance

The following is an example of a lozenge formulation.

Ingredient % w/w Sugar 75-80 Corn syrup  1-20 Flavour oil 1-2 NaF0.01-0.05 Biofilm inhibitor (Oxantel pamoate) 0.3 Mg stearate 1-5 Waterbalance

The following is an example of a gingival massage cream formulation.

Ingredient % w/w White petrolatum 8.0 Propylene glycol 4.0 Stearylalcohol 8.0 Polyethylene Glycol 4000 25.0 Polyethylene Glycol 400 37.0Sucrose monostearate 0.5 Chlorhexidine gluconate 0.1 Biofilm inhibitor(Oxantel pamoate) 0.3 Water balance

The following is an example of a periodontal gel formulation.

Ingredient % w/w Pluronic F127 (from BASF) 20.0 Stearyl alcohol 8.0Oxantel pamoate 3.0 Colloidal silicon dioxide (such as Aerosil ® 200 ™)1.0 Chlorhexidine gluconate 0.1 Water balance

The following is an example of a chewing gum formulation.

Ingredient % w/w Gum base 30.0 Calcium carbonate 2.0 Crystallinesorbitol 53.0 Glycerine 0.5 Flavour oil 0.1 Biofilm inhibitor (Oxantelpamoate) 0.3 Water balance

TABLE 1 Quantification of predetermined BSA ratios using ¹⁶O/¹⁸Oproteolytic labelling Expected ratio 1:1a) Triplicate analysis Meanration (±SD) CCTESLVNR 0.83 0.84 0.88 0.85 ± 0.03 DLGEEHFK 0.95 1.060.85 0.95 ± 0.10 EACFKVEGPK 1.09 1.12 1.09 1.10 ± 0.02 ECCDKPLLEK 1.010.96 0.87 0.94 ± 0.07 EYEATLEECCAK 1.05 1.01 1.05 1.04 ± 0.02 LVTDLTKVHK0.86 0.91 1.02 0.93 ± 0.08 RHPEYAVSVLLR 1.07 0.96 0.94 0.99 ± 0.07YICDNQDTISSK 1.00 1.15 1.03 1.06 ± 0.08 Average 0.98 ± 0.10 1.00 ± 0.100.97 ± 0.09 0.98 ± 0.08 Average of all peptidew ID** 0.98 ± 0.08 CV ofall peptides ID 13.1% Expected ratio 2:1 b) Expected ratio 1:2 b)(18O/16O) (18O/16O) QTALVELLK 1.92 0.44 (2.27) 2.10 LVNELTEFAK 2.45 0.46(2.17) 2.31 RHPEYAVSVLLR 1.82 0.42 (2.36) 2.09 LGEYGFQNALIVR 2.21 0.43(2.31) 2.26 MPCTEDYLSLILNR 2.59 0.40 (2.50) 2.55 KVPQVSTPTLVEVSR 2.350.39 (2.57) 2.46 LFTFHADICTLPDTEK 1.72 0.44 (2.27) 2.00 RPCFSALTPDETYVPK1.82 0.52 (1.92) 1.87 Average 2.11 ± 0.33 2.30 ± 0.20 2.24 ± 0.24Average of all peptides ID*** 2.22 ± 0.26 CV of all peptides ID 11.75%Expected ratio 1:5 Expected ratio 10:1 (18O/16O) (18O/16O) AEFVEVTK0.232 (4.32) AEFVEVTK 12.38 CCTESLVNR 0.184 (5.42) QTAALVELLK 10.40SHCIAEVEK 0.176 (5.67) LVNELTEFAK 14.17 ECCDKPLLEK 0.169 (5.91)FKDLGEEHFK 9.41 HPEYAVSVLLR 0.218 (4.58) HPEYAVSVLLR 11.76 YICDNQDTISSK0.187 (5.36) YICDNQDTISSK 10.16 LKECCDKPLLEK 0.252 (3.97) RHPEYAVSVLLR10.14 SLHTLFGDELCK 0.183 (5.45) SLHTLFGDELCK 7.58 RHPEYAVSVLLR 0.201(4.97) EYEATLEECCAK 14.07 VPQVSTPTLVEVSR 0.206 (4.86) ETYGDMADCCEK 12.67ECCHGDLLECADDR 0.298 (3.35) LGEYGFQNALIVR 9.36 LFTFHADICTLPDTEK 0.210(4.76) VPQVSTPTLVEVSR 8.34 KVPQVSTPTLVEVSR 8.86 LFTFHADICTLPDTEK 11.08RPCFSALTPDETYVPK 10.26 Average 0.21 ± 0.04 (4.90 ± 0.75) 10.74 ± 2.04 CVof all pepides ID 15.26% 18.95% a) For expected ratio of 1:1, onlypeptides that were identified in all three separate experiments areincluded in this table b) For expected ratio of 2:1 and 1:2, onlypeptides that were identified in both experiments are included in thistable ** n = 55 *** n = 24

TABLE 2 List of the 81 proteins identified from both biologicalreplicates of the P. gingivalis cell envelope fraction. An abundanceratio >1 indicates a higher abundance of the protein in the biofilm withrespect to the planktonic state. If the ratio differs from one with morethan 3-fold SD (0.26) from the predetermined BSA ratios (>1.78 or<0.56), the proteins were considered to have significantly changed.Based on their mean ratios, proteins highlighted in grey representsignificant changes.

^(a)Locations as determined by the CELLO program; EX: Extracellular, OM:Outer membrane, IM: Inner membrane, PP: Periplasm, CY: Cytoplasm; UN:Unknown ^(b)Maximum Mascot peptide ion score/identity threshold^(c)Normalized ratio; B = biofilm, P = Planktonic, Normalization processas described in experimental procedures ^(d)SE = Standard error of themean ^(e)Ranking and grouping as decribed in FIG. 4B ^(f)Proteinsidentified only in this study !SE measurements not carried out due tounresolved/overlapping of one of the 3 peptides *Due to presence ofidentical peptides between these proteins, ratios derived were frompeptides that were unique to these proteins only. Values in parenthesisare total number of peptides matched. **Due to unresolved/overlappingpeaks

TABLE 3 Proteomic and transcriptomic analyses of genes products involvedin glutamate/aspartate catabolism in P. gingivalis during growth inheme-limitation compared to heme-excess. Shading indicates proteins thatare predicted to be encoded in operons.

¹Highest scoring peptide score/threshold score (P = 0.05) ²Total numberof independent peptide identification events for each protein ³Number ofunique ICAT-labelled peptides identified for each protein ⁴Averageratios of all quantified peptides for each protein in fold change(Heme-limitation/excess) ⁵NS no statistically significant changedetected ⁶Only identified in the microarray analysis C* DenotesICAT-modified cysteine

TABLE 4 The 24 P. gingivalis polypeptides selected as targets forinhibition of biofilm formation.

*These accession numbers provide a sequence for the P. gingivalisproteins referred to in the specification. Sequences corresponding tothe accession numbers are incorporated by reference.

TABLE 5 Proteomic and transcriptomic analyses of P. gingivalis grown inheme-limitation compared to heme-excess. Shading indicates proteins thatare predicted to be encoded in operons.

¹Highest scoring peptide score/threshold score (P = 0.05) ²Total numberof independent peptide identification events for each protein ³Number ofunique ICAT-labelled peptides identified for each protein ⁴Averageratios of all quantified peptides for each protein in fold change(Heme-limitation/excess) ⁵NS no statistically significant changedetected ⁶Only identified in the microarray analysis C* DenotesICAT-modified cysteine

TABLE 6 Effect of adding Oxantel to 16 h P. gingivalis biofilm asdetermined using COMSTAT on a 3-channel flow cell system.

¹Percentage reduction based on average of both replicates over thecontrol sample. ^(a.)P <0.01 compared to Control ^(b.)P <0.05 comparedto Control

TABLE 7 Effect of oxantel, morantel or Thiabendazole on growth of P.gingivalis W50 over 50 h MGT h⁻¹ MGT h⁻¹ MGT h⁻¹ MIC (DMSO) (31.25 μM)(62.5 μM) Oxantel 112 μM 6.62 19.28 23.77 Morantel 2800 μM 6.85 10.9711.28 Thiabendazole >3 mM* 6.25 6.80 6.22 *MIC at higher concentrationswere not able to be determined due to the insolubility of thiabendazoleat >3 mM.

TABLE 8 Effect of Oxantel on growth of P. gingivalis ATCC 33277 over 50h MGT h⁻¹ MGT h⁻¹ MGT h⁻¹ MIC (DMSO) (31.25 μM) (62.5 μM) Oxantel 125 μM6.62 10.0 24.0

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1. A method of preventing, inhibiting or reducing a P. gingivalisbiofilm in a subject comprising administering to the subject apharmaceutical composition comprising an inhibiting agent of apolypeptide that modulates biofilm formation and/or biofilm development.2. A method of preventing, inhibiting or treating a P. gingivalisinfection in a subject comprising administering to the subject apharmaceutical composition comprising an inhibiting agent of apolypeptide that modulates biofilm formation and/or development.
 3. Amethod of claim 1 wherein the polypeptide is an enzyme.
 4. A method ofclaim 1 wherein the polypeptide is fumarate reductase.
 5. A method ofclaim 1 wherein the inhibiting agent is an inhibitor of any one of theproteins corresponding to accession numbers selected from the groupconsisting of AAQ65462, AAQ65742, AAQ66991, AAQ65800, AAQ65561,AAQ66831, AAQ66797, AAQ66469, AAQ66587, AAQ66654, AAQ66977, AAQ65797,AAQ65867, AAQ65868, AAQ65416, AAQ65449, AAQ66051, AAQ66377, AAQ66444,AAQ66538, AAQ67117, AAQ67118, AAQ66642 and AAQ66643.
 6. A method ofclaim 1 wherein the inhibiting agent is an inhibitor of fumaratereductase activity.
 7. A method of claim 1 wherein the inhibiting agentis an inhibitor of AAQ66642 or AAQ66643 or both.
 8. A method ofpreventing, inhibiting or reducing a P. gingivalis biofilm in a subjectcomprising administering to the subject a pharmaceutical compositioncomprising an inhibiting agent, wherein the inhibiting agent is selectedfrom the group consisting of oxantel, morantel or thiabendazole.
 9. Acomposition useful in the prevention, inhibition or treatment of P.gingivalis infection, the composition comprising an inhibiting agentsuch as an antagonist, or combination of antagonists of a polypeptide soas to reduce or inhibit biofilm formation and/or development.
 10. Acomposition useful in the prevention, inhibition or treatment of P.gingivalis infection, the composition comprising an inhibiting agentsuch as an antagonist, or combination of antagonists of a polypeptide soas to reduce or inhibit biofilm formation and/or development, thecomposition further comprising an antibiotic.
 11. A composition usefulin the prevention or treatment of periodontal disease or treatment of P.gingivalis infection comprising an inhibiting agent and an antibiotic.12. A composition useful in the prevention or treatment of periodontaldisease, the composition comprising an antagonist or combination ofantagonists of a polypeptide so as to reduce or inhibit biofilmformation and/or development.
 13. A method of treatment of periodontaldisease comprising administering a therapeutically effective amount of acomposition according to claim 9 to a patient.
 14. A method of claim 2wherein the polypeptide is an enzyme.
 15. A method of claim 2 whereinthe polypeptide is fumarate reductase.
 16. A method of claim 2 whereinthe inhibiting agent is an inhibitor of any one of the proteinscorresponding to accession numbers selected from the group consisting ofAAQ65462, AAQ65742, AAQ66991, AAQ65800, AAQ65561, AAQ66831, AAQ66797,AAQ66469, AAQ66587, AAQ66654, AAQ66977, AAQ65797, AAQ65867, AAQ65868,AAQ65416, AAQ65449, AAQ66051, AAQ66377, AAQ66444, AAQ66538, AAQ67117,AAQ67118, AAQ66642 and AAQ66643.
 17. A method of claim 2 wherein theinhibiting agent is an inhibitor of fumarate reductase activity.
 18. Amethod of claim 2 wherein the inhibiting agent is an inhibitor ofAAQ66642 or AAQ66643 or both.